CAJ | 학술논문

目的探讨显微外科辅助技术在阴茎离断再植术中的应用价值.方法20只成年比格犬进行阴茎海绵体完全离断后再植术.随机分成2组,观察组10只在10倍放大镜下采用显微外科技术辅助手术,对照组10只采用在肉眼直视条件下进行手术;手术方式均采用同一组手术成员统一术式,缝合阴茎海绵体、尿道海绵体,两侧阴茎背血管;比较两组手术时间,术中失血量、血管吻合时间、阴茎背血管吻合成功例数、术后远端阴茎颜色、温度、血流通畅程度、术后远端阴茎坏死例数、术后排尿功能恢复情况等各项指标.结果观察组10只血管吻合一次成功例数高达38根(其中静脉20根、动脉18根),而对照组10只血管吻合一次成功例数达22根(其中静脉14根,动脉8根),两者比较有显著性差异(P<0.05);观察组平均手术时间120min、平均血管吻合时间68min、平均失血量80ml;而对照组平均手术时间106min、平均血管吻合时间50min、平均失血量70ml.观察组术后多普勒超声阴茎血管狭窄1例,而对照组出现血管狭窄6例.观察组术后阴茎坏死例数为0例,而对照组阴茎坏死例数为3例.结论显微外科技术辅助阴茎离断再植可明显提高血管吻合成功率,显著改善远端阴茎血流供应,缩短远端阴茎恢复时间.
목적탐토현미외과보조기술재음경리단재식술중적응용개치.방법20지성년비격견진행음경해면체완전리단후재식술.수궤분성2조,관찰조10지재10배방대경하채용현미외과기술보조수술,대조조10지채용재육안직시조건하진행수술;수술방식균채용동일조수술성원통일술식,봉합음경해면체、뇨도해면체,량측음경배혈관;비교량조수술시간,술중실혈량、혈관문합시간、음경배혈관문합성공례수、술후원단음경안색、온도、혈류통창정도、술후원단음경배사례수、술후배뇨공능회복정황등각항지표.결과관찰조10지혈관문합일차성공례수고체38근(기중정맥20근、동맥18근),이대조조10지혈관문합일차성공례수체22근(기중정맥14근,동맥8근),량자비교유현저성차이(P<0.05);관찰조평균수술시간120min、평균혈관문합시간68min、평균실혈량80ml;이대조조평균수술시간106min、평균혈관문합시간50min、평균실혈량70ml.관찰조술후다보륵초성음경혈관협착1례,이대조조출현혈관협착6례.관찰조술후음경배사례수위0례,이대조조음경배사례수위3례.결론현미외과기술보조음경리단재식가명현제고혈관문합성공솔,현저개선원단음경혈류공응,축단원단음경회복시간.
Objective To invetigate the value of microsurgical technique in autoallergic penile replantation. Methods Twenty adult beagle dogs who underwent the procedure of autoallergic penile replantation, were divided into two groups randomly. Each group was 10 dogs. The dogs in the observation group were treated by microsurgical techniques using 10-time magnifying glass, while the dogs in the control group were done by general surgery at the condition of orthophoria. The same operation modus was carried out by same operation team including the same technique to suture dorsal vessels, running sutre the urethra and corporal bodies. Some indexes such as the operation time, blood loss volume, vessel suturing time, the number of successful suturing dorsal vessels, the color and temperature of replantation penile post-operation, the number of penile necrosis, et al were comparartively analyzed. Results The number of once time successful suturing dorsal vessels were 38 items including 20 veins and 18 arteries for all 10 cases in the observation group, while the number in the control group was 22 items including 14 veins and 8 arteries. The difference was significant between these two groups (P<0.05). In the observation group, the average operation time was 120min, and the average vessel suturing time were 68min, and the average blood loss volume were 80ml. However, in the control group, the average operation time was 106min, and the average vessel suturing time were 50min, and the average blood loss volume were 70ml. The incidence rate of hemadostenosis post-operation in the observation group was 1%, while in the control group was 60%. The number of penile necrosis post-operation in the observation group was 0 case, but in the control group was 3 cases. Conclusion Microsurgical technique asisted penile replantation can improve the successful rate of vascular anastomosis and blood flow supplying in the penis obviously obvisouly. ,and shorten the revovery time.