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目的探讨带蒂岛状皮瓣加盖法保留尿道板一期尿道成形术治疗小儿尿道下裂的效果。方法采用带蒂岛状皮瓣加盖法保留尿道板治疗尿道下裂26例,其中无阴茎下弯18例,阴茎轻度下弯8例。本组病例尿道板完好,尿道口位于阴茎体中或远端。结果新建尿道全部成活,1例漏尿,术后8个月手术修补治愈。随访3个月~2年,2例尿道外口狭窄,1例经尿道扩张治愈,另1例合并新尿道憩室样扩张,二期手术治愈。结论带蒂岛状皮瓣加盖法,将包皮内板及内外板交界部转移到腹侧制成的新尿道质地柔软、表面光滑、伸展性强,成形的尿道顺应性好,管腔宽,血供较好,保留尿道板可以减少或预防尿瘘、尿道狭窄等并发症的发生。
Objective To investigate the effect of pedicle urethral flap retainer urethral plate urethroplasty in the treatment of pediatric hypospadias. Methods 26 patients with urethral hypospadias were treated with pedicled island-shaped skin flap and lidding method. Among them, there were 18 cases of penile hypospadias and 8 cases of mild penis bulging. The urethral plate in this group intact urethra in the penis or distal. Results The newly built urethra all survived, 1 case had urine leakage and was surgically repaired 8 months after operation. Followed up for 3 months to 2 years, 2 cases of urethral stenosis, 1 case of urethral dilatation and cure, the other 1 case of merged new urethral diverticula dilation, two surgical cure. Conclusions The pedicle island flap flap method is used to transfer the preputial inner and outer plates to the ventral side to create a new urethra with soft texture, smooth surface, strong extensibility, good hypospadial compliance, wide lumen, Blood supply is better, retaining the urethral plate can reduce or prevent the occurrence of complications such as urinary fistula, urethral stricture.