CAJ | 학술논문

目的探讨一次性包皮环切缝合器配合复方利多卡因乳膏联合利多卡因注射液在包皮环切术中的应用效果.方法 2013年9月至2014年11月收治的120例包皮过长患者,年龄11～49岁.其中包茎11例.术前检查血常规、凝血功能无异常.将患者按入院日期单双号分为一次性包皮环切缝合器组(S组)和传统包皮环切术组(T组),每组各60例,两组中包茎患者分别为6例和5例,两组临床资料比较差异无统计学意义(P＞0.05).每组各选取30例(S+C组和T+C组)采用复方利多卡因乳膏联合利多卡因注射液局部麻醉,每组余下30例(S+L组和T+L组)采用利多卡因注射液局部麻醉.比较4组的手术时间、麻醉疼痛评分、术中及术后疼痛评分、失血量、术后并发症、术后外观满意度、伤口愈合时间等.结果 S+C组、S+L组、T+C组、T+L组的手术时间分别为(5.3±1.5)、(4.9±1.4)、(31.6±3.4)、(32.0±3.3) min;术中出血量分别为(0.6±0.4)、(0.8±0.5)、(6.9±2.4)、(7.5 ±2.1)ml;麻醉疼痛评分分别为0.6±0.6、3.2±3.9、2.5±1.0、0.5±0.6;术中疼痛评分分别为0.8±0.9、1.4±0.8、2.2±1.1、3.1±1.1;术后24h疼痛评分分别为1.6±0.9、2.2±0.8、2.6±1.3、4.4±1.1;术后48 h疼痛评分分别为0.7±0.6、0.8±0.9、2.4±0.8、2.8±0.7;术后并发症发生率分别为6.6％(2/30)、10.0％ (3/30)、26.6％(8/30)、33.4％ (10/30);术后满意度分别为93.4％ (28/30)、96.7％(29/30)、70.4％(22/30)、80.0％(24/30),S+C组与S+L组、T+C组、T+L组比较差异均有统计意义(P＜0.05).S+C组的切口愈合时间为(13.7±1.5)d,与S+L组(13.5±1.7)d、T+C组(14.2±1.3)d、T+L组(14.1±1.6)d比较差异均无统计意义(P＞0.05).结论复方利多卡因乳膏联合利多卡因注射液麻醉下采用一次性包皮环切缝合器行包皮环切术的疗效和安全性优于利多卡因注射液麻醉下的传统包皮环切术.
목적 탐토일차성포피배절봉합기배합복방리다잡인유고연합리다잡인주사액재포피배절술중적응용효과.방법 2013년9월지2014년11월수치적120례포피과장환자,년령11～49세.기중포경11례.술전검사혈상규、응혈공능무이상.장환자안입원일기단쌍호분위일차성포피배절봉합기조(S조)화전통포피배절술조(T조),매조각60례,량조중포경환자분별위6례화5례,량조림상자료비교차이무통계학의의(P＞0.05).매조각선취30례(S+C조화T+C조)채용복방리다잡인유고연합리다잡인주사액국부마취,매조여하30례(S+L조화T+L조)채용리다잡인주사액국부마취.비교4조적수술시간、마취동통평분、술중급술후동통평분、실혈량、술후병발증、술후외관만의도、상구유합시간등.결과 S+C조、S+L조、T+C조、T+L조적수술시간분별위(5.3±1.5)、(4.9±1.4)、(31.6±3.4)、(32.0±3.3) min;술중출혈량분별위(0.6±0.4)、(0.8±0.5)、(6.9±2.4)、(7.5 ±2.1)ml;마취동통평분분별위0.6±0.6、3.2±3.9、2.5±1.0、0.5±0.6;술중동통평분분별위0.8±0.9、1.4±0.8、2.2±1.1、3.1±1.1;술후24h동통평분분별위1.6±0.9、2.2±0.8、2.6±1.3、4.4±1.1;술후48 h동통평분분별위0.7±0.6、0.8±0.9、2.4±0.8、2.8±0.7;술후병발증발생솔분별위6.6％(2/30)、10.0％ (3/30)、26.6％(8/30)、33.4％ (10/30);술후만의도분별위93.4％ (28/30)、96.7％(29/30)、70.4％(22/30)、80.0％(24/30),S+C조여S+L조、T+C조、T+L조비교차이균유통계의의(P＜0.05).S+C조적절구유합시간위(13.7±1.5)d,여S+L조(13.5±1.7)d、T+C조(14.2±1.3)d、T+L조(14.1±1.6)d비교차이균무통계의의(P＞0.05).결론 복방리다잡인유고연합리다잡인주사액마취하채용일차성포피배절봉합기행포피배절술적료효화안전성우우리다잡인주사액마취하적전통포피배절술.
Objective To investigate the application efficacy of disposable circumcision stapler with compound lidocaine cream combined with lidocaine injection in the circumcision.Methods From September 2013 to November 2014,120 cases (11 cases of redundant prepuce phimosis patients), were divided into disposable circumcision suture group (S group, 60 cases) and conventional circumcision (T group, 60 eases) ,two groups had no statistically significant difference at patient age and wrapping case (6 cases phimosis of S group,5 cases phimosis of T group) (P ＞0.05.Patient's age ranged from 11 to 49 years.30 patients in each group were treated with lidocaine cream combined with lidocaine injection,and another 30 patients were treated with a local anesthetic lidocaine injection.Comparisons were conducted among the four groups on the operation time, anesthesia, intraoperative and postoperative pain score, blood loss and postoperative complications, postoperative appearance satisfaction, wound healing time.Results For the disposable circumcision stapler with lidocaine cream combined with lidocaine injection group, disposable circumcision stapler with lidocaine injection group, sleeve circumcision with lidocaine cream combined with lidocaine injection group and sleeve circumcision with lidocaine injection group, the operation time was (5.3 ± 1.5) min, (4.9 ± 1.4) min, (31.6 ± 3.4) min, (32.0 ± 3.3) min respectively, blood loss was (0.6 ± 0.4) ml, (0.8 ± 0.5) ml, (6.9 ± 2.4) ml, (7.5 ± 2.1) ml respectively, narcotic pain score was 0.6 ± 0.6,3.2 ±3.9,2.5 ± 1.0,0.5 ±0.6,intraoperative pain score was 0.8 ±0.9,1.4 ±0.8,2.2 ± 1.1,3.1 ± 1.1,postoperative 24 h pain score was 1.6 ±0.9,2.2 ±0.8,2.6 ± 1.3,4.4 ± 1.1, postoperative 48h pain score was 0.7 ±0.6,0.8 ±0.9,2.4 ±0.8,2.8 ±0.7, wound healing time was (13.7 ±1.5)d,(13.5 ± 1.7)d, (14.2 ± 1.3) d, (14.1 ± 1.6) d, the rate of postoperative complications was 6.6％ (2/30), 10.0％ (3/30),26.6％ (8/30), 33.4％ (10/30), satisfaction rate of appearance was 93.4％ (28/30), 96.7％ (29/30),70.4％ (22/30), 80.0％ (24/30).Compared with sleeve circumcision with lidocain injection group,disposable circumcision stapler with lidocaine cream combined with lidocaine injection had a shorter operation time, less pain, less bleeding, higher appearance satisfaction rate and lower incidence of complications (P ＜ 0.05), wound healing time had no significant difference (P ＞ 0.05).Conclusion Application of the disposable circumcision stapler with lidocaine cream combined with lidocaine injection on circumcision is safe and has got better clinical outcomes.