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目的探讨尿瘘修复的一种新技术。方法采用减张双蒂皮瓣法修复尿瘘患者24例,手术分两期于局部麻醉下进行:Ⅰ期行局部瘘口缝合,通过皮肤减张技术的原理于瘘口旁设计双蒂皮瓣,局部推进后无张力缝合瘘口处皮肤创缘,遗留减张创面;Ⅱ期手术于10~14d待瘘口处切口愈合良好后进行,经皮下分离后减张创面直接拉拢缝合,术后10~14d根据切口愈合情况拆除缝线。结果 24例患者术后皮瓣均Ⅰ期愈合,未出现感染及愈合不良,术后排尿及外形良好。随访6~24个月,均无尿道狭窄及尿瘘复发。结论减张双蒂皮瓣法是治疗尿瘘的一种有效方法,其操作简单,效果可靠,对外形影响较小。
Objective To explore a new technique for the repair of urinary fistula. Methods Twenty-four patients with urinary fistula were treated with double-flap reduction. The operation was performed in two phases under local anesthesia. Stage I was performed with local fistula suture. Double flap pedicled flap was designed beside the fistula by the principle of skin desensitization. After local advancement, no tension suture fistula at the wound edge of the wound, leaving the wound surface reduction; Ⅱ surgery in 10 ~ 14d to be fistula incision healed well after the subcutaneous separation of wounds directly wound suture closure, 10 ~ 14d According to incision healing situation to remove the suture. Results All the 24 cases had primary healed skin flap, no infection and poor healing, postoperative urination and good appearance. Follow-up 6 to 24 months, no urethral stricture and recurrence of urinary fistula. Conclusion Reduction of double pedicle flap method is an effective treatment of urinary fistula, its simple operation, the effect is reliable, less impact on the shape.