V形瓣法在尿道外口开大及阴茎头成形术中的临床应用

发布时间：2018-04-28 15:21

本文选题：外科皮瓣 + 阴茎头型尿道下裂　；参考：《北京协和医学院》2017年硕士论文

【摘要】：[目的]:探讨尿道下裂修复手术后尿道外口回缩和阴茎头成形的方法。[方法]:通过术前设计水滴状切口,将异常尿道外口与阴茎组织在腹侧进行适当游离,同时在尿道外口背侧行纵行切开狭窄段尿道,并将切开扩大的两侧尿道口组织向两侧阴茎头组织背侧移位缝合,原异常尿道外口腹侧组织瓣翻转形成尿道外口腹侧壁,同时将两侧阴茎头组织瓣向腹侧移位,相对缝合成锥状完整阴茎头。[结果]:从2008年1月至2013年12月份,在此5年间,我们统计尿道下裂临床修复28例患者,包括治疗类型为与阴茎头型尿道下裂、尿道下裂修复术后尿道外口退缩和尿道外口狭窄等。我们从2009年1月至2014年12月以电话及网络随访28例患者,随访时间从术后1个月至12个月,每位患者平均随访时间为1个月,7位患者因地址变更而失访,剩下21例随访患者均成功,术后均未出现尿道外口狭窄,阴茎头外形及尿道外口退缩得到明显的改善。[结论]:应用尿道外口背侧V形瓣及两侧阴茎头组织瓣的合理地向腹侧移位,可以矫治尿道下裂修复术后尿道外口退缩、尿道外口狭窄,改善扁平阴茎头的形态,并可用于远端型尿道下裂的修复。
[Abstract]:[Objective] to discuss the method of urethral retraction and penile head forming after repair of hypospadias. [method]: through the design of a water drop incision before operation, the abnormal urethral opening and the penis tissue were properly dissociated at the ventral side, while the urethra was cut through the dorsal urethral opening, and the enlarged incision on the bilateral urethral orifice was carried out. Both sides of the head of the penis were displaced on the dorsal side of the penis, and the original abnormal urethral ventral tissue flap turned into the outer ventral wall of the urethra, and the lateral penis flap was shifted to the ventral side of the penis. [results]: from January 2008 to December 2013, we have counted 28 cases of hypospadias repair in the 5 years. 28 patients were followed up from January 2009 to December 2014 by telephone and network. The follow-up period was from 1 months to 12 months from 1 months to 12 months. The average follow-up time of each patient was 1 months, and 7 patients were changed by address. The remaining 21 cases were followed up. No stricture of the urethral opening was found, the shape of the head of the penis and the withdrawal of the urethra were obviously improved. [Conclusion]: the proper transposition of the dorsal V flap of the urethra and the lateral penis flap to the ventral flap can be used to rectify the withdrawal of the urethral opening after the repair of the hypospadias and the external urethral opening. Stenosis can improve the shape of the flat penis and can be used for the repair of distal hypospadias.

【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R699

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