【摘要】 目的:探讨Duckett术式一期整形联合阴囊皮瓣在重度尿道下裂合并小阴茎(SHWM)治疗中的应用价值。方法:回顾性分析2016年1月至2020年5月本院收治的80例SHWM患儿,其中采用Duckett术式一期整形治疗患儿为对照组,采用Duckett术式一期整形联合阴囊皮瓣治疗患儿为观察组。统计2组患儿的手术效果指标(手术成功率、尿瘘、尿道狭窄、尿道憩室、尿瘘合并尿道狭窄)。采用小儿阴茎感知评分量表(PPPS)评估家属和医生对术后阴茎外观(阴茎长度、尿道外口位置与形态、阴茎头形态、包皮分布、整体阴茎外观)的满意度。结果:观察组的尿瘘发生率明显低于对照组,手术成功率明显高于对照组(P<0.05)。观察组家属和医生的包皮分布评分、整体阴茎外观评分和PPPS平均分均明显高于对照组(P<0.05)。结论:Duckett术式一期整形联合阴囊皮瓣治疗SHWM可降低尿瘘发生率,提高手术成功率和改善SHWM患儿阴茎的外观。更多还原

【Abstract】 Objective: To investigate the application of Duckett’s procedure of one-stage urethroplasty combined with scrotal flap in the treatment of severe hypospadias with micropenis( SHWM). Methods: The clinical data of 80 children with SHWM from Jan2016 to May 2020 were retrospectively analyzed. The children treated with one-stage Duckett’ s urethroplasty were selected as the control group,while the children treated with one-stage Duckett’ s urethroplasty combined with scrotal flap were selected as the observation group. The surgical success rate,the incidence of urinary fistula,urethral stricture,urethral diverticulum,and urinary fistula with urethral stricture were compared between the two groups. The pediatric penile perception score( PPPS) was used to evaluate the satisfaction of family members and doctors on the appearance of penis after operation( penis length,external urethral opening position and shape,penis head shape,prepuce distribution,and overall appearance of penis). Results: Compared with the control group,the incidence of urinary fistula in the observation group was significantly lower,and the operation success rate was significantly higher( P<0. 05). The scores of prepuce distribution,penis appearance and PPPS of family members and doctors in the observation group were significantly higher than those in the control group( P < 0. 05). Conclusion: Application of Duckett’ s procedure of one-stage urethroplasty combined with scrotal flap can reduce the incidence of urinary fistula,improve the success rate of operation and the appearance of penis in SHWM children.更多还原