摘要
目的研究使用一次性包皮环切缝合器行包皮环切术后患儿吻合钉脱落时间及影响因素。方法前瞻性选取2020年7月至2021年7月于厦门市海沧医院泌尿外科就诊的210例包皮过长或包茎患儿,使用一次性包皮环切缝合器对其行包皮环切术,根据年龄将患儿分为低龄组(6~9岁,103例)与高龄组(10~12岁,107例),根据术前选取缝合器型号(F12/F15)的不同将患儿分为F12组(49例)与F15组(161例),根据术中是否因阴茎切口出血需予以5-0可吸收线缝合止血将患儿分为缝合组(23例)与未缝合组(187例),统计并比较低龄组与高龄组、F12组与F15组、缝合组与未缝合组吻合钉完全脱落情况。结果所有患儿均顺利完成手术,均从术后第2周开始出现吻合钉脱落情况。高龄组术后第4、5周的吻合钉脱落率均高于低龄组,差异有统计学意义(P<0.05);高龄组术后第6周的吻合钉脱落率虽高于低龄组,但差异无统计学意义(P>0.05)。F15组术后第4、5、6周的吻合钉脱落率虽高于F12组,但差异均无统计学意义(P>0.05)。未缝合组术后第4、5、6周的吻合钉脱落率虽高于缝合组,但差异均无统计学意义(P>0.05)。对于吻合钉未能完全脱落的患儿,需于术后第7周返院随诊时于局部麻醉下行吻合钉取出治疗。结论使用一次性包皮环切缝合器行包皮环切术吻合钉多于术后第4~6周自行脱落;高龄患儿因自主活动较多可加快吻合钉脱落,且缝合器型号差异以及术中出血缝合与否并不延迟吻合钉脱落时间。
Objective The shedding time and its influencing factors of anastomotic nail after redundant circumcision with disposable redundant circumcision stapler in children were investigated.Methods From July 2020 to July 2021 in the Urology Department of Xiamen Haicang Hospital,210 children with redundant prepuce or phimosis were prospectively selected,and they were treated by redundant circumcision with disposable redundant circumcision stapler.According to different ages,the children were divided into a younger age group(6~9 years old,103 cases)and an older age group(10~12 years old,107 cases).According to the stapler model selected before operation,the children were divided into a F12 group(49 cases)and a F15 group(161 cases).According to 5-0 absorbable thread sutured hemostasis was required or not due to penile incision bleeding during the operation,the children were divided into a suture group(23 cases)and a non-suture group(187 cases).The shedding conditions of anastomotic nail between the younger age group and the older age group,between the F12 group and the F15 group,between the suture group and the non-suture group were counted and analyzed.Results All operations on the children were successfully completed,and all the anastomotic nails started to shed two weeks after surgery.The shedding rate of anastomotic nail at the fourth and fifth weeks after surgery in the older age group were both higher than those in the younger age group,with statistically significant differences(P<0.05);and the shedding rate of anastomotic nail at the sixth week after surgery in the older age group was higher than that in the younger age group,but the difference was not statistically significant difference(P>0.05).The shedding rate of anastomotic nail at the fourth,fifth and sixth weeks after surgery in the F15 group were all higher than those in the F12 group,but the differences were not statistically significant(P>0.05).The shedding rate of anastomotic nail at the fourth,fifth and sixth weeks after surgery in the non-suture group were all higher than those in the suture group,but the differences were not statistically significant(P>0.05).Children whose anastomotic nail didn't fall off completely should treated by removing the anastomotic nail under local anesthesia at the seventh week in the postoperative follow-up visit.Conclusion Most of the anastomotic nails can shed automatically at fourth to sixth week after redundant circumcision with disposable redundant circumcision stapler;and older age children can accelerate the shedding of anastomotic nails due to more spontaneous activities,and the difference in suture models and intraoperative bleeding sutures do not delay the shedding time of anastomotic nails.
作者
饶明煌
应臣
王剑平
李超
Rao Minghuang;Ying Chen;Wang Jianping;Li Chao(Urology Department of Xiamen Haicang Hospital,Xiamen Fujian 361000,China)
出处
《医疗装备》
2022年第11期5-8,共4页
Medical Equipment
关键词
包皮过长
包茎
一次性包皮环切缝合器
包皮环切术
吻合钉脱落时间
影响因素
Redundant prepuce
Phimosis
Disposable redundant circumcision stapler
Redundant circumcision
Shedding time of anastomotic nail
Influencing factor
