摘要
目的总结Snodgrass尿道成形术治疗小儿尿道下裂的适应证及方法、并评价其疗效。方法总结行Snodgrass尿道成形术的78例尿道下裂患儿的病例资料,其中冠状沟型18例,阴茎体型54例,阴茎阴囊型6例。14例为尿道成型失败者,52例合并阴茎下弯畸形行阴茎背侧12点处白膜折叠短缩,留置导尿管12～14d,拔管后常规前尿道扩张。结果术后随访4个月～2年,一次手术成功71例(91.0%),阴茎外观正常,无下弯畸形,尿道口位于阴茎头正位,成纵行裂隙状,排尿通畅,无尿道狭窄。7例(9.0%)发生尿道瘘,经尿道扩张后自愈2例,4例已行尿瘘修补术,1例再行Snodgrass尿道成形术,均成功。结论Snodgrass尿道成形术适用于近、远端型,无或有轻中度阴茎下弯.尿道板发育良好的患儿,手术保留了尿道板,操作简单,并发症较少,手术成形效果好,易于掌握及推广。对尿道成形失败而阴茎所剩皮肤极少者也是一个非常有效的手术方法。
Objective To summarize the hypospadias,evaluate therapeutic effect of Snodgrass proper indication and methods for the repair of urethroplasty. Methods Tubularized incised plate urethroplasty was performed in 78 cases of hypospadias including 18 coronal,54 corpus of penis,6 penoseorotal types.Their age was from 16 months to 18 years with a mean 4.5 years.14 children had a history of failed urethroplasty.52 cases complicated with ehordees deformation,white tuoniea was folded and shorten at 12 points of the penis dorsal lateral.Bladder drainage was maintain for 12-14 days,anterior urethral was dilated after withdrawing the drainage. Results The pa- tients were followed up for 4 months-2 years and a good function neourethra with a vertical Slit- like meatus was observed.There was no ehordee or stricture.7 patients （9.0%） had urethral fistula,2 were self healing after urethral dilatation,4 were corrected with urinary fistula repair,one had been corrected with Snodgrass urethroplasty. Conclusions Tubulafized incised plate urethroplasty can be used in distal and proximal hypospadias repair including those with no or mild ehordee.It is especially indicated for patients without enough penile skin after failed urethroplasty.Exeellent functional and cosmetic results with fewer complication can be gained by using Snodgrass operation.
出处
《临床小儿外科杂志》
CAS
2005年第5期327-329,共3页
Journal of Clinical Pediatric Surgery
