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目的总结双极电凝在尿道下裂手术中应用的经验。方法先天性尿道下裂280例,其中冠状沟型26例,阴茎体型142例,阴茎阴囊型80例,会阴型32例。年龄1～8岁,平均4岁。分为A、B两组:A组140例,术中不采用双极电凝,采用压迫法、结扎法止血;B组140例,术中采用双极电凝止血。所有患者均采用保留尿道板尿道成形或横形带蒂包皮瓣尿道成形。比较其止血纱布使用的块数,手术所需时间,术后敷料血痂情况及其并发症。结果术中未使用双极电凝组与使用双极电凝组其术中所用止血纱布块数为(7.67±0.96)块和(2.12±0.63)块,手术时间为(112.52±3.88)min和(95.83±2.25)min,术后敷料血痂数为3.65±0.70和0.91±0.37,两组各指标差异有统计学意义(P<0.01)。前者并发症尿瘘、尿道狭窄较后者增加。结论先天性尿道下裂患儿手术中采用双极电凝止血,术野清晰,手术操作方便,手术并发症少,值得推广。
Objective To summarize the experience of bipolar coagulation in hypospadias surgery. Methods 280 cases of congenital hypospadias, including 26 cases of coronal type, 142 cases of penis size, penis scrotum 80 cases, 32 cases of perineal. Ages 1 to 8 years old, average 4 years old. Divided into A, B two groups: A group of 140 cases, intraoperative use of bipolar coagulation, compression method, ligation to stop bleeding; B group of 140 cases, intraoperative use of bipolar coagulation to stop bleeding. All patients underwent urethral urethral plaque preservation or lateral pedicle flap urethroplasty. Comparison of the number of hemostasis gauze used, the time required for surgery, blood clots and postoperative dressing scab and its complications. Results The number of hemostatic gauze used in the operation without bipolar coagulation and bipolar coagulation was (7.67 ± 0.96) and (2.12 ± 0.63) blocks, the operation time was (112.52 ± 3.88) min and (95.83 ± 2.25) min. The number of blood scab in postoperative dressing was 3.65 ± 0.70 and 0.91 ± 0.37, respectively. There was significant difference between the two groups (P <0.01). The former complications of urinary fistula, urethral stricture increased compared with the latter. Conclusions Children with congenital hypospadias are treated with bipolar electrocoagulation and have a clear operative field. They are easy to operate and have fewer complications. They are worthy of popularization.