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目的探讨包皮带蒂岛状皮瓣Ⅰ期尿道成形术治疗尿道下裂的疗效和影响因素。方法近10年来对入选的78例先天性尿道下裂患者采取包皮岛状皮瓣尿道成形术,并观察疗效。结果 78例患者手术均一次成功,出院符合治愈标准62例(79.5%)。术后3~5 d出现腹侧包皮红肿、感染并最终出现吻合口瘘11例(14.1%);尿道狭窄5例(6.4%),经过尿道扩张后改善。结论包皮岛状皮瓣尿道Ⅰ期成形术适用于合并有阴茎下弯的尿道下裂。尿瘘为最主要并发症,精细的手术操作、有效的术后护理是手术成功的保障。
Objective To investigate the efficacy and influencing factors of urethral hypospadias treated with stage Ⅰ urethroplasty with island flap. Methods In the past 10 years, 78 patients with congenital hypospadias were treated with urethroplasty of the island skin flap and the curative effect was observed. Results All the 78 patients were operated successfully, and 62 patients (79.5%) were discharged according to the standard of cure. There were 11 cases (14.1%) of anastomotic fistula infection and 5 cases (6.4%) of urethral stricture, which were improved after urethral dilatation. Conclusion The preputial island flap urethroplasty is suitable for hypospadias with penile hypospadias. Urinary fistula is the most important complication, fine surgical operation, effective postoperative care is the guarantee of successful operation.