中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2011年
1期
4-7
,共4页
李养群%李森恺%刘晓吉%唐勇%陈文%杨喆%赵穆欣
李養群%李森愷%劉曉吉%唐勇%陳文%楊喆%趙穆訢
리양군%리삼개%류효길%당용%진문%양철%조목흔
先天性尿道下裂%幼儿%口腔黏膜卷%阴囊筋膜皮瓣
先天性尿道下裂%幼兒%口腔黏膜捲%陰囊觔膜皮瓣
선천성뇨도하렬%유인%구강점막권%음낭근막피판
Congenital hypospadias%Infancy%Tubed oral mucosa%Fascio-cutaneous flaps,scrotum
目的 探讨修复幼儿期先天性尿道下裂的手术方法.方法 矫直阴茎后,应用口腔黏膜卷管游离移植预制缺损段尿道,二期进行吻接,同时应用以阴囊动脉为蒂的阴囊筋膜皮瓣覆盖创面,皮瓣范围包括阴囊中缝区在内的阴囊区域.结果 2007年1月至2010年5月,于临床应用42例.手术过程顺利,应用口腔黏膜卷长3.0～4.0 cm,直径0.6～0.8 cm;阴囊筋膜皮瓣最宽1.5cm,最长3.0 cm.术后除2例患者出现阴囊皮瓣远端血运障碍而漏尿,术后1～2周内经换药后自行愈合外,其余患者均一期愈合.术后有26例获得随访,时间为6个月至3年,阴茎无弯曲,自行排尿通畅,无尿道狭窄及尿瘘,阴茎外形良好.结论 应用口腔黏膜卷管游离移植预制缺损段尿道,二期尿道吻接,同时应用血运良好的阴囊筋膜皮瓣覆盖创面,是一种修复幼儿期尿道下裂的良好方法.
目的 探討脩複幼兒期先天性尿道下裂的手術方法.方法 矯直陰莖後,應用口腔黏膜捲管遊離移植預製缺損段尿道,二期進行吻接,同時應用以陰囊動脈為蒂的陰囊觔膜皮瓣覆蓋創麵,皮瓣範圍包括陰囊中縫區在內的陰囊區域.結果 2007年1月至2010年5月,于臨床應用42例.手術過程順利,應用口腔黏膜捲長3.0～4.0 cm,直徑0.6～0.8 cm;陰囊觔膜皮瓣最寬1.5cm,最長3.0 cm.術後除2例患者齣現陰囊皮瓣遠耑血運障礙而漏尿,術後1～2週內經換藥後自行愈閤外,其餘患者均一期愈閤.術後有26例穫得隨訪,時間為6箇月至3年,陰莖無彎麯,自行排尿通暢,無尿道狹窄及尿瘺,陰莖外形良好.結論 應用口腔黏膜捲管遊離移植預製缺損段尿道,二期尿道吻接,同時應用血運良好的陰囊觔膜皮瓣覆蓋創麵,是一種脩複幼兒期尿道下裂的良好方法.
목적 탐토수복유인기선천성뇨도하렬적수술방법.방법 교직음경후,응용구강점막권관유리이식예제결손단뇨도,이기진행문접,동시응용이음낭동맥위체적음낭근막피판복개창면,피판범위포괄음낭중봉구재내적음낭구역.결과 2007년1월지2010년5월,우림상응용42례.수술과정순리,응용구강점막권장3.0～4.0 cm,직경0.6～0.8 cm;음낭근막피판최관1.5cm,최장3.0 cm.술후제2례환자출현음낭피판원단혈운장애이루뇨,술후1～2주내경환약후자행유합외,기여환자균일기유합.술후유26례획득수방,시간위6개월지3년,음경무만곡,자행배뇨통창,무뇨도협착급뇨루,음경외형량호.결론 응용구강점막권관유리이식예제결손단뇨도,이기뇨도문접,동시응용혈운량호적음낭근막피판복개창면,시일충수복유인기뇨도하렬적량호방법.
Objective To discuss the treatment of congenital hypospadias in infancy. Methods After correction of chordee, the tubed oral mucosa was used to prefabricate urethra in penis as free graft.The uretheral anastomosis was performed at the second stage. The scrotum fascia flap, pedicled with scrotal artery, was transferred to cover the penile defect. Results From Jan. 2007 to May 2010, 42 cases were treated. The tubed oral mucosa was 3.0-4.0 cm in length ,and 0. 6-0. 8 cm in diameter. The maximum size of scrotum flap was 1.5 cm × 3.0 cm. Uretheral fistula happened in two cases due to necrosis at the distal end of scrotal flap, which was healed spontaneously after dressing for 1-2 weeks. Primary healing was achieved in all the other cases. After operation, the 26 cases have been visited for 6 months to 3 years, no urethra fistula , narrow and the penis curved. There is an universal urinate for oneself and a good form.Conclusions The tubed oral mucosa can be used to prefabricate urethera, which is anastomosed at the second stage. The tubed oral mucosa combined with scrotal fascial flap which has a reliable blood supply,is very suitable for hypospadias in infancy.
