【作者】 范登信；

【导师】 张祖明；

【作者基本信息】 安徽医科大学 ， 外科学， 2009， 硕士

【摘要】 目的:总结尿道板纵切卷管法(TIP)与加盖岛状皮瓣法(OIF)尿道成形术治疗尿道下裂的疗效,并对其进行比较,探讨术式选择的条件。方法:回顾性总结42例TIP术和26例OIF术治疗尿道下裂的临床资料,TIP术组年龄2-13岁,平均4.76岁。其中Ⅱ型3例,Ⅳ型1例。38例为初次行尿道成形术者,4例为初次尿道成形术失败,再次行尿道成形术者;OIF术组年龄2-10岁,平均4.72岁,其中Ⅱ型23例,Ⅲ型3例,均为初次行尿道成形术者。结果: TIP术:平均手术时间80 min,有尿瘘7例,阴茎头裂开1例,无尿道狭窄,但有尿道外口狭窄1例,3例再次尿道成形术者未发生并发症;OIF术:平均手术时间115min ,有尿瘘5例,阴茎头裂开l例,无尿道狭窄。两种手术方法的尿瘘、尿道狭窄、阴茎头裂开、一次手术成功率,差异无统计学意义(p〉0.05),但两组平均手术时间,差异有统计学意义(p〈0.05)。结论: TIP与OIF尿道成形术可用于阴茎头冠状沟、阴茎体、阴茎阴囊型尿道下裂的治疗, TIP术操作简单,且更适用于初次手术失败、需再次行尿道成形术的病例。对于阴茎发育差.尿道板条件不好的初次手术病例,仍以选择OIF术为宜。更多还原

【Abstract】 Objective: To evaluate and compare the efficacy of the tubularized incised plate (TIP) urethroplasty and the Onlay island flap (OIF) urethroplasty in hypospadias repair, and approach the choice between the two.Methods: The clinical data of 42 cases of TIP procedures and 26 cases of OIF procedures were analyzed Retrospectively.TIP group were 2-13 years old,with an average age of 4.76,includingⅡtype 3 cases, IV type 1 case,38 were primary surgery,4 were repeat surgery ;OIF group were 2-10 years old, with an average ageof 4.72,includingⅡtype 23 cases,and III type 3 cases,all were primary surgery.Results: In TIP group,80 min with mean duration of surgery, 7cases with urethral fistula, 1 case with neourethral dehiscence,none with urethral stricture ,and 1 case with outside of urethral stricture,3 repeat surgery cases without complications ;In OIF group,115 min with mean duration of surgery,5 cases with urethral fistula,1case with neourethral dehiscence,and none with urethral stricture.There was no statistically significant difference in the incidence of fistula、stricture、dehiscence and success rate of onestage operation between the TIP group and the OIF group (p〉0.05),But there was statistically significant difference in the mean duration of surgery between these two groups (p〈0.05).Conclusions: TIP urethroplasty and OIF urethroplasty can be used in distal and proximal hypospadias, TIP urethroplasty is more simplified than OIF urethroplasty, and more applicable to the primary surgery failed cases;OIF urethroplasty is suitable for the primary surgery patients with poor development of penis and urethral plate.更多还原