【摘要】 目的:比较分析通过传统的包皮环切手术、商环及包皮切割的缝合器对包皮过长或者包茎的手术治疗效果,并分析其安全性。方法:选取在2015年1月至2017年1月在平湖市中医院施包皮环切术的包皮及包茎患者446例,随机将其分为切割缝合器组175例(其中包皮过长143例、包茎32例),商环组184例,传统环切组87例。通过分析各项指标,来评价分析各组术式的疗效。结果:传统环切术组与商环组和切割缝合器组相比较,出血量显著变大,差异具有统计学意义(P<0.05);手术耗时以及术后1h疼痛感,传统环切术组高于商环组和切割缝合器组,差异具有统计学意义(P<0.05);伤口愈合时间传统环切术组明显短于商环组,差异具有统计学意义(P<0.05);诊疗费用,切割缝合器组高于商环组高于传统环切术组,差异具有统计学意义(P<0.05);7d后疼痛程度评分,传统环切术组低于商环组,高于切割缝合器组,差异具有统计学意义(P<0.05);3组相比较,满意率传统环切术组低于商环组低于切割缝合器组,差异具有统计学意义(P<0.05);感染率,切割缝合器组最低,商环组低于传统环切术组,阴茎水肿率商环组高于其他两组,出血并发症概率传统环切术组高于其他两组,差异具有统计学意义(P<0.05);术后并发症传统环切手术组高于商环组,商环组高于切割缝合器组,差异具有统计学意义(P<0.05)。结论:使用切割缝合器治疗包皮过长及包茎具有手术快捷、术后并发症少、创伤小等特点,临床效果好于传统环切术组及商环组,但是治疗费用较高,且临床范围小。商环环切术具有时间短,操作简单等优点,但拆环会引起疼痛,商环切口也需要长时间愈合;传统环切手术的费用比较少,适合的范围也较大,但手术步骤比较复杂,且对患者创伤较大,并发症多。患者适用何种诊疗方式,需要综合考虑。更多还原

【Abstract】 Objective: To compare thetreatment efficiency and safety of circumcision suture device,Shang ring andtraditional circumcision in the treatment of prepuce or phimosis. Methods: 446 patients with prepuce or phimosis in our hospitalfrom January 2015 to January 2017 were selected and randomy divided into circumcision suture device group( n = 175),Shang ring group( n = 184) and traditional circumcision group( n = 87). Relevant indicators were analyzed to evaluate the treatment efficiency of each group. Results: Compared with thecircumcision suture device group and Shang ring group,the blood loss was significantly larger in the traditional circumcision group and the surgery time and postoperative pain was significantly higher,all with statistical significance( P < 0. 05). The wound healing time in traditional circumcision group was significantly shorter than that of Shang ringgroup,with statistically significant difference( P < 0. 05). The treatment cost of circumcision suture device group was the highest,followed by the Shang ring group and traditional circumcisiongroup accordingly,with significant differences between groups( P < 0. 05). The pain rating in the three groups was the highest in the Shang ring group,followed by the traditional circumcision group and circumcision suture device group accordingly,with significant differences betweengroups( P < 0. 05). The satisfaction rate was the lowest in the traditionalcircumcision group and highest in the circumcision suture device group,with significant differences between groups( P < 0. 05). The infection rate was the lowest in the circumcision suture device group,followed by Shang ring group and traditional circumcision group respectively; the incidence of penile edema was higher in the Shang ring group than that of the other two groups; the incidence of bleeding complication was the highest in the traditional circumcision group,all with statistically significant differences( P < 0. 05). The incidence of postoperative complications was the highest in the traditionalcircumcision group,followed by the Shang ring group and the circumcision suture device group,with statistically significant differences( P < 0. 05). Conclusions: The use of circumcision suture devicein the treatment of prepuce orphimosis has the advantages of shorteroperation time,fewerpostoperative complications,lesstrauma and better clinical application range islimited. Shang ring is simple and easy to operate,but the healing needs more time. The traditional circumcision costs low with wide application range,but the trauma is large and the operation is complicated with more complications. Therefore,all kinds of factors should be considered to decide the kind of treatment.更多还原