CAJ | 학술논문

目的：比较一次性包皮环切缝合器与一次性包皮环切吻合器、传统包皮环切术三种术式的临床疗效。方法将到门诊就诊的包茎和包皮过长患者随机分成三组，采用三种手术方法，一次性包皮环切缝合器49例，一次性包皮环切吻合器46例，传统组61例，在其安全性、术式优越性及疗效等方面进行对比。结果包皮环切缝合器组和环切吻合器组手术时间为（6.2±1.6）min和（6.3±1.7）min，优于传统包皮环切术组（29.2±4.9）min，失血量三组中传统包皮环切术组最多[（1.0±0.2）ml vs.（1.0±0.2）ml vs.（10.9±2.3） ml]，差异有统计学意义（P<0.05）；术后并发症三组中包皮环切缝合器组最低（8.2%vs.13.0%vs.13.1%），但无统计差异（P>0.05）；包皮环切缝合器组和环切吻合器组术后无需换药，切口愈合好，外形美观，患者满意度较高；环切吻合器组拆环疼痛评分高（8.8±1.0），伤口愈合时间最长，包皮环切缝合器组患者疼痛、出血等并发症更低。结论应用一次性包皮环切缝合器进行包皮环切术，手术更为简单、方便与安全，并发症少，效果更为满意，值得在临床中推广应用。
목적：비교일차성포피배절봉합기여일차성포피배절문합기、전통포피배절술삼충술식적림상료효。방법장도문진취진적포경화포피과장환자수궤분성삼조，채용삼충수술방법，일차성포피배절봉합기49례，일차성포피배절문합기46례，전통조61례，재기안전성、술식우월성급료효등방면진행대비。결과포피배절봉합기조화배절문합기조수술시간위（6.2±1.6）min화（6.3±1.7）min，우우전통포피배절술조（29.2±4.9）min，실혈량삼조중전통포피배절술조최다[（1.0±0.2）ml vs.（1.0±0.2）ml vs.（10.9±2.3） ml]，차이유통계학의의（P<0.05）；술후병발증삼조중포피배절봉합기조최저（8.2%vs.13.0%vs.13.1%），단무통계차이（P>0.05）；포피배절봉합기조화배절문합기조술후무수환약，절구유합호，외형미관，환자만의도교고；배절문합기조탁배동통평분고（8.8±1.0），상구유합시간최장，포피배절봉합기조환자동통、출혈등병발증경저。결론응용일차성포피배절봉합기진행포피배절술，수술경위간단、방편여안전，병발증소，효과경위만의，치득재림상중추엄응용。
Objective To compare the advantage and disadvantage of disposable circumcision suture device, disposable circumcision stapler and conventional circumcision. Methods From June 2012 to December 2012, according to the wishes of patients,people who were receiving circumcision in our hospital were divided into three groups:disposable circumcision suture device(DCSD group, n=49), disposable circumcision stapler (DCS group, n=46)and conventional circumcision(CC group, n=61). The operation time,pain score, blood loss,wound healing time,rate of postoperative complications, postoperative satisfaction with penile appearance, and treatment cost were compared among the groups. Results DCSD group and DCS group showed significantly shorter operation time[(6.2±1.6) min vs. (6.3±1.7) min vs. (29.2±4.9) min], less blood loss[(1.0±0.2) ml vs. (1.0±0.2) ml vs. (10.9±2.3) ml], lower pain score in 24 hours, higher rate of postoperative satisfaction with penile appearance. DCS group showed longer wound healing time and higher pain score when removing the ring, while DCSD group was similar to CC group in healing time.But DCSD group’s cost was the most among three groups. No significant difference existed in the rate of postoperative complications among the three groups(8.2% vs. 13.0% vs. 13.1%) (P>0.05). Conclusion The DCSD is a good approach for circumcision with short operation time, few blood loss, and satisfied postoperative appearance of the penile,short wound healing time,however,the cost is high.