三种包皮环切术的临床比较与分析

目的:观察并评价改良后一钳式环切法临床应用优势。方法:回顾2009年12月至2012年3月间在我院实施的870例包皮环切术资料,对比分析改良一钳法(470例)、传统一钳法(337例)、袖套切除法(63例)三组术式在手术时间、术中疼痛发生率、系带损伤率、患者对外观满意率及并发症(血肿、水肿、延迟愈合、切口狭窄)等临床指标间的差异。结果:改良一钳法的手术时间(min)、术中疼痛发生率小于传统一钳法及袖套切除法(20.88±4.96 vs 26.6±6.48 vs 56.22±7.09,5.5%vs 28.2%vs 100%,P<0.01),袖套切除法在术后短期水肿发生率方面低于改良一钳法和传统一钳法(1.6%vs 10.9%vs 14.8%,P<0.05),改良一钳法的系带损伤率、血肿发生率、切口狭窄率均低于传统一钳法(0 vs 3.6%,0.4%vs 5.9%,0 vs 0.9%,P<0.01),改良一钳法的外观满意度高于传统一钳法及袖套切除法(98.1%vs 93.2%vs 95.2%,P<0.01),而各组的术后切口延迟愈合发生率无统计学差异。结论:根据患者具体情况选择包皮环切术式。其中改良一钳法因适用范围广、手术时间短,系带安全及外形美观,适用于绝大部分的包皮过长及包茎患者。

Clinical Comparison of Three Ways of Male Circumcision

Objective: To evaluate the clinical advantages of improved one clamp circumcision.Methods: There were 870 cases with the operation of circumcision in our hospital from December 2009 to March 2012,which categorized into 3 groups,improved one clamp circumcision(n=470 group A),traditional one clamp circumcision(n=337 group B) and sleeve circumcision(n=63,group C).Indices including operation time,operative pain incidence,frenum injury rate,satisfaction rate of postoperative appearance and complications incidence of hematoma,edema,delay healing and stenosis of incision were compared and analyzed among 3 groups.Results: The operation time(min),the pain incidence in group A were significantly lower than group B and C(20.88±4.96 vs 26.6±6.48 vs 56.22±7.09,5.5% vs 28.2% vs 100%,respectively.P<0.01),while the incidence of edema in group C was lower than the other 2 groups(1.6% vs 10.9% vs 14.8% P<0.01).The incidence of frenum injury,hematoma and stenosis in group A were lower than group B(0 vs 3.6%,0.4% vs 5.9%,0 vs 0.9% P<0.01).The satisfaction rate of postoperative appearance in group A was higher than the other 2 groups(98.1% vs 93.2% vs 95.2% P<0.01).There is no difference among the 3 groups in the incidence of delay healing of incision.Conclusions: An optimal choice of ways of male circumcision should be determined according to the individual characters of patients.The improved one clamp circumcision is clinical applicable as its advantages of wider indications,shorter operation time,safer frenum,better postoperative appearance in the most cases of redundant prepuce and phimosis.