Duckett术和Koyanagi术修复近端型尿道下裂的疗效分析

潘永斌　梁裕柱　王少梅　吴敏秋　梁萍宝　邱伟全

【摘要】 目的：探讨Duckett术和Koyanagi术在近端型尿道下裂修复中的临床疗效。方法：回顾性分析本院泌尿外科2012年1月-2016年12月间收治的71例近端型尿道下裂患儿的临床资料，其中35例行Duckett术记为Duckett术组，36例行Koyanagi术记为Koyanagi术组。比较两组手术时间、治愈率以及并发症发生情况。结果：Duckett术组手术时间为（135.2±8.6） min，Koyanagi术组手术时间为（129.5±11.3） min，两组手术时间比较，差异无统计学意义（t=1.397，P>0.05）；两组治愈率均为100%，差异无统计学意义（字2=0.000，P>0.05）。Koyanagi术组并发症发生率为22.22%，明显低于Duckett术组的40.00%，差异有统计学意义（字2=7.661，P<0.05）。结论：对于本院泌尿外科采用Koyanagi术修复近端型尿道下裂相比Duckett术，并发症发生率更低，宜在临床推广应用。

【关键词】 Duckett术； Koyanagi术； 近端型尿道下裂

Analysis of the Effect of Duckett Surgery and Koyanagi Surgery on the Repair of Proximal Hypospadias/PAN Yongbin，LIANG Yuzhu，WANG Shaomei，et al.//Medical Innovation of China，2018，15（12）：016-019

【Abstract】 Objective：To investigate the clinical effect of Duckett surgery and Koyanagis surgery on the repair of proximal hypospadias.Method：The clinical data of 71 children with proximal hypospadias treated in Department of Urology our hospital from January 2012 to December 2016 were retrospectively analyzed.35 cases of Duckett surgery were recorded as Duckett surgery group，36 cases of Koyanagi surgery were recorded as Koyanagi surgery group.The operative time，cure rate and complications were compared between the two groups.Result：The operative time of Duckett surgery group was（135.2±8.6） min，and the operative time of Koyanagi surgery group was（129.5±11.3） min，there was no significant difference between the two groups（t=1.397，P>0.05）；the cure rate of the two groups was 100%，the difference was not statistically significant（字2=0.000，P>0.05）.The incidence of complications in the Koyanagi surgery group was 22.22%，which was significantly lower than 40.00% of the Duckett surgery group，the difference was statistically significant（字2=7.661，P<0.05）.Conclusion：In Department of Urology our hospital，the incidence of complications in the repair of proximal hypospadias by Koyanagi surgery is lower than that in Duckett surgery，should be clinically applied.

【Key words】 Duckett surgery； Koyanagi surgery； Proximal hypospadias

First-authors address：Foshan Nanhai Maternal and Child Health Care Hospital，Foshan 528200，China

doi：10.3969/j.issn.1674-4985.2018.12.005

近端型尿道下裂通常是指相對较严重的，开口位于阴茎近端，阴囊于阴茎交界之处，阴囊以及会阴等部位的尿道下裂[1-2]。近端型尿道下裂由于缺损较长，手术修复难度相对较大，且术后并发症发生率较高[3-4]。目前临床上对于近端型尿道下裂的治疗方法较多，不同方法各有其优缺点，目前仍然没有一种方法是通用满意[5]。从目前国内外临床研究来看，对于近端型尿道下裂大多数研究者都倾向于单期手术，常用的方法主要是Duckett术和Koyanagi术[6-7]。为了探讨Duckett术和Koyanagi术在近端型尿道下裂修复中的临床疗效，为本院泌尿外科近端型尿道下裂患儿的治疗提供参考，笔者回顾性分析了本院泌尿外科2012年1月-2016年12月间收治的71例近端型尿道下裂患儿的临床资料进行研究，取得了满意的结果，现具体报道如下。

1 资料与方法

1.1 一般资料 回顾性分析本院泌尿外科2012年1月-2016年12月间收治的71例近端型尿道下裂患儿的临床资料，纳入标准：（1）年龄为0～3岁；