改良尿道板纵切卷管法在治疗小儿尿道下裂中的应用价值分析[摘要]目的探?改良尿道板纵切卷管法在治疗小儿尿道下裂中的应用价值。方法选取2014年3月～2016年3月在我院外科治疗的82例小儿尿道下裂患儿作为研究对象，按照随机数字表法将其分为两组，每组各41例。对照组患者采用传统手术方法治疗，观察组患者采用改良尿道板纵切卷管法治疗。比较两组患者的治疗效果、并发症发生情况，记录观察组患儿的术后尿瘘发生率。结果术后随访6～15个月，观察组患者的治疗总有效率为97.56%，明显高于对照组的85.37%，差异有统计学意义（P<0.05），患儿阴茎形状正常，尿道开口正位，排尿通畅，阴茎无弯曲。术后，观察组患者尿瘘、尿道狭窄、感染等并发症发生率明显低于对照组，差异有统计学意义（P<0.05）。观察组患儿的阴茎阴囊型的尿瘘发生率最高，其次为阴茎体型，冠状沟型未发生尿瘘，阴茎体型、冠状沟型和阴茎阴囊型术后尿瘘的发生率比较，差异有统计学意义（P<0.05）。尿瘘者行尿瘘修补术后痊愈，尿道狭窄者经尿道扩张术后痊愈。结论改良尿道板纵切卷管法在治疗小儿尿道下裂中有良好的应用价值，能提高一次手术成功率，降低术后并发症和二次手术的概率，且能加快患儿术后恢复，具有积极的临床意义。[关键词]小儿尿道下裂；改良尿道板纵切卷管法；应用价值[]R726.9[文献标识码]A[]1674-4721（2018）2（a）-0119-04[Abstract]ObjectiveToinvestigatetheapplicationvalueofmodifiedtubularizedincisedplate（TIP）urethroplastyinthetreatmentofhypospadiasinchildren.MethodsAltogether82casesofpediatrichypospadiaswhoacceptedsurgicaltreatmentinourhospitalfromMarch2014toMarch2016wereselectedassubjectsandwererandomlydividedintotwogroupsaccordingtotherandomnumbertablemethod，41casesineachgroup.Thetraditionalsurgicalmethodwasusedinthecontrolgroup；while，theobservationgroupweretreatedwithmodifiedTIPurethroplasty.Thesurgicaleffectivenessandcomplicationsofpatientsbetweentwogroupswerecompared，theincidenceofpostoperativeurinaryfistulawasrecordedintheobservationgroup.ResultsThetotaleffectiverateofpatientsintheobservationgroupofpostoperativefollow-up6-15monthswas97.56%，whichwassignificantlyhigherthanthe85.37%inthecontrolgroup，andthedifferencewasstatisticallysignificant（P<0.05），thepenisshapeofpatientswerenormalwithrighturethralopeningposition，smoothurinationandnopenilecurvature.Aftertheoperation，theincidenceofurinaryfistula，urethralstrictureandinfectionintheobservationgroupweresignificantlylowerthanthoseinthecontrolgroup，andthedifferenceswerestatisticallysignificant（P<0.05）.Penisscrotaltypehasthehighestincidenceofurinaryfistulaofpatientsintheobservationgroup，followedbythepenissizetype，coronaryditchtypewithouturinaryfistula.Theincidenceofurinaryfistulainthepenissizetype，coronarysulcustypeandpenisscrotaltypewerecompared，andthedifferencewasstatisticallysignificant（P<0.05）.Thepatientswithurinaryfistulaunderwentfistulousneoplastyandwererecovered，andpatientswithurinarytractstenosisweretreatedwithurethraldilatationandrecovered.ConclusionThemodifiedTIPurethroplastyhasgoodapplicationvalueinthetreatmentofchildrenwithhypospadias，canimprovethesuccessrateofoperation，reducetheriskofpostoperativecomplicationsandreoperations，andcanacceleratethepostoperativerecoveryinchildren，whichhaspositiveclinicalsignificance.[Keywords]Childrenhypospadias；Modifiedtubularizedincisedplate；Applicationvalue小儿尿道下裂是常见的小儿泌尿系统生殖器畸形，其发病机制复杂，解剖结构呈现尿道异位开口于尿道腹侧，且阴茎下曲有不同程度畸形。该疾病采用手术治疗是唯一的治愈办法，由于患儿多无法站立解尿，容易引发心理问题，因此临床多主张早期...