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1、小儿包皮粘连微创治疗探析【摘要】目的探讨包皮粘连分离的微创治疗方法,以及术后疼痛不适消退时间与包皮水肿,复发之间的关系。方法对2004~2008年间的400例不同年龄不同程度的患儿进行包皮粘连分离术并通过术中配合程度及术后的疼痛不适消退的时间进行对比评价,观察盐酸利多卡因胶浆对术后包皮水肿,疼痛程度的变化规律及复发情况。(对照组200例:采用传统的方法即不用麻醉,手法分离包皮粘连;观察组200例:应用盐酸利多卡因胶浆表面麻醉下行包皮粘连分离术)。结果对照组术中配合程度差,术后疼痛时间长,水肿重(15%的患者包皮外口水肿直径大于阴茎根部)。观察组术中配合好,术后疼痛时间短,水肿
2、轻(2.5%的患者包皮外口水肿直径大于阴茎根部)。因术后水肿轻,疼痛小,患儿心理恐惧感较小,更易于配合家长完成后续治疗,观察组术后无1例复发(对照组20%)。结论应用盐酸利多卡因胶浆能安全,确切的进行无痛性包皮粘连分离术,并可通过明显的降低及缩短术后疼痛而减轻术后包皮水肿,避免并发症,减少复发。【关键词】包皮粘连分离术;微创【Abstract】ObjectiveToinvestigatetheseparationofnon-surgicalforeskinadhesions6minimallyinvasivetreatmentmethods,andthepaindoesnot
3、subsidetimeandforeskinedema,recurrencerelations.Methods400casesbetween2004~2008differentlevelsofchildrenofdifferentagesforforeskinadhesionsdissectionthroughthesurgerywiththedegreeandpost-operativepainanddiscomfortsubsidedtimeforcomparativeassessment,observationofLidocaineHydrochlorideMucila
4、geofsurgeryforeskinedemaaftertheimpactandextentofchangesinchildrenwithpostoperativepainandrecurrenceofthelaw.(Controlgroupof200cases:usingthetraditionalmethod,thatnoanesthesia,separationtechniquesforeskinadhesions,afterapplicationoferythromycinointment;ObserverGroup200cases:applicationoflid
5、ocaineanesthesiacircumcisionslurrysurfaceadhesiondissection).ResultsThepatientsinthecontrolgroup,withthedegreeofdifference(needexternalcompression),andpostoperativepainlastedlonger,about4~6hours,afterheavyedema(15%ofpatientsoutsidethemouthforeskinedemaisequal6toorgreaterthanthediameterofthe
6、penisroot).Groupofpatientsintheobservationgroupwithgood0.5~1hoursafteraslightpain,language,solacecanbenootherdiscomfort.Edemaandtoalesserextent(2.5%ofpatientsoutsidethemouthforeskinedemadiameterequaltoorgreaterthanthepenis).Lesserextentduetopostoperativeedema,childrenwithasenseofpsychologic
7、alfearofsmaller,moreeasilywiththeparentstocompletethefollow-uptreatment,theobservationgroupnoonecasesofpostoperativerecurrence(controlgroup20%).ConclusionLidocaineslurrycanbesafe,theexactnatureoftheconductofpainlessseparationofpreputialadhesionssurgery,a
