中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
3期
37-39
,共3页
李华斌%林文%叶祝芹%罗鹏%黎海燕%邓丽君%徐小慧%林育萍%袁文清%邱延平%崔永红%钟雨
李華斌%林文%葉祝芹%囉鵬%黎海燕%鄧麗君%徐小慧%林育萍%袁文清%邱延平%崔永紅%鐘雨
리화빈%림문%협축근%라붕%려해연%산려군%서소혜%림육평%원문청%구연평%최영홍%종우
包茎%包皮过长%术式选择
包莖%包皮過長%術式選擇
포경%포피과장%술식선택
Phimosis%Prepuce%Surgical options
目的：探讨传统包皮环切术和新型环切法（又称包皮套环法、包皮环扎法）治疗包茎、包皮过长术式选择和临床疗效。方法：回顾性分析本院外科采用传统环切法（500例）和新型环切法（又称套环法、环扎法）（2500例）治疗包茎或包皮过长共计3000例患者的临床资料，比较两种术式手术时间、术中出血量、术后疼痛与不适时间、术者和患者对手术满意程度、术后并发症、愈合时间、包皮水肿、患者对术后外观满意度。结果：显示新型环切法（套环法）手术简单耗时短、极少出血无须止血。术后伤口出血极少25例（占1%），无线结、无须换药拆线、次日可洗澡、边沿整齐等方面优于传统环切法手术（P<0.05）。术后偶有包皮龟头粘连及嵌顿50例（占2%）。适应儿童。传统环切法手术繁琐费时、有出血需止血。术后伤口偶有血肿10例（占2%）、残留止血线结、需要来院换药拆线、边沿不整齐，不能洗澡。术后不发生包皮龟头粘连及嵌顿优于套环法，适应成年人。结论：两种术式各有优缺点，笔者认为对于包皮过长、包茎传统环切法较适应成年人。新型环切法（套环法）较适应儿童。术式选择还要根据手术者对不同术式的手术技巧、手术熟练程度和患者的要求等方面考虑。
目的：探討傳統包皮環切術和新型環切法（又稱包皮套環法、包皮環扎法）治療包莖、包皮過長術式選擇和臨床療效。方法：迴顧性分析本院外科採用傳統環切法（500例）和新型環切法（又稱套環法、環扎法）（2500例）治療包莖或包皮過長共計3000例患者的臨床資料，比較兩種術式手術時間、術中齣血量、術後疼痛與不適時間、術者和患者對手術滿意程度、術後併髮癥、愈閤時間、包皮水腫、患者對術後外觀滿意度。結果：顯示新型環切法（套環法）手術簡單耗時短、極少齣血無鬚止血。術後傷口齣血極少25例（佔1%），無線結、無鬚換藥拆線、次日可洗澡、邊沿整齊等方麵優于傳統環切法手術（P<0.05）。術後偶有包皮龜頭粘連及嵌頓50例（佔2%）。適應兒童。傳統環切法手術繁瑣費時、有齣血需止血。術後傷口偶有血腫10例（佔2%）、殘留止血線結、需要來院換藥拆線、邊沿不整齊，不能洗澡。術後不髮生包皮龜頭粘連及嵌頓優于套環法，適應成年人。結論：兩種術式各有優缺點，筆者認為對于包皮過長、包莖傳統環切法較適應成年人。新型環切法（套環法）較適應兒童。術式選擇還要根據手術者對不同術式的手術技巧、手術熟練程度和患者的要求等方麵攷慮。
목적：탐토전통포피배절술화신형배절법（우칭포피투배법、포피배찰법）치료포경、포피과장술식선택화림상료효。방법：회고성분석본원외과채용전통배절법（500례）화신형배절법（우칭투배법、배찰법）（2500례）치료포경혹포피과장공계3000례환자적림상자료，비교량충술식수술시간、술중출혈량、술후동통여불괄시간、술자화환자대수술만의정도、술후병발증、유합시간、포피수종、환자대술후외관만의도。결과：현시신형배절법（투배법）수술간단모시단、겁소출혈무수지혈。술후상구출혈겁소25례（점1%），무선결、무수환약탁선、차일가세조、변연정제등방면우우전통배절법수술（P<0.05）。술후우유포피구두점련급감돈50례（점2%）。괄응인동。전통배절법수술번쇄비시、유출혈수지혈。술후상구우유혈종10례（점2%）、잔류지혈선결、수요래원환약탁선、변연불정제，불능세조。술후불발생포피구두점련급감돈우우투배법，괄응성년인。결론：량충술식각유우결점，필자인위대우포피과장、포경전통배절법교괄응성년인。신형배절법（투배법）교괄응인동。술식선택환요근거수술자대불동술식적수술기교、수술숙련정도화환자적요구등방면고필。
Objective: To investigate options and clinical efficacy of phimosis, prepuce surgical using traditional and new circumcision act.Method: The clinical data of 3000 patients were retrospectively analyzed, they used the traditional method (n=500) and a new ring-cut method (n=2500) treatment of phimosis or prepuce in our hospital. Then the two methods including the operative time, blood loss, postoperative pain and discomfort time, the surgeon and patient satisfaction with surgery, postoperative complications, healing time, the foreskin edema, the patient satisfaction with postoperative appearance degrees were compared.Result:New circumcision spended short time, accompanied by less bleeding. There were 25 cases of postoperative wound bleeding (1%), but had no knot. Patients didn’t need dressing and stitches and could take a bath. 50 cases happened adhesions and incarcerated of Foreskin and glans after surgery. This surgery was adapted to child. Traditional circumcision wasted of time and was easy bleeding. There were 10 cases of postoperative wound hematoma (2%), residual bleeding knot. Edges of the incision was irregular. Patients needed dressing and stitches and could not take a bath. Adhesions and incarcerated of Foreskin and glans didn’t happen after surgery. This surgery was adapted to adult.Conclusion: The traditional circumcision is adapted to adult and the new circumcision is adapted to child for phimosis and prepuce. Surgical options should also be considered according to the different surgical techniques, surgical proficiency, the patient’s request and so on.
