脱细胞异体真皮基质治疗重度小儿尿道下裂效果观察

摘要

Objective To investigate the clinical effect of allograft acellular dermal matrix (AEM) in treating severe hypospadias in children.Methods Totally 43 children with severe hypospadias from January 2009to March 2013 were retrospectively analyzed, in them t9 cases received AEM treatment (observation group) and 24 cases received traditional urethroplasty (control group).The incidences of anastomosis fistula and urethral stenosis, the operation duration were compared between group.Results The incidence of anastomosis fistula in observation group was significantly lower than that in control group [10.5％ (2/19) vs 41.7％ (10/24)] (x2 =5.11, P ＜ 0.05);the incidence of urethral stenosis were not significantly different between groups [5.3％(1/19) vs 25.0％ (6/24)] (x2 =1.76, P ＞ 0.05).The operation duration in observation group was significantly shorter than that in control group [(97 ± 10) min vs (121 ± 24) min] (P ＜ 0.05).In observation group, no rejection, hair formation, calculus, graft contraction occurred.Conclusion Compared with traditional urethroplasty, AEM has good effect and is easy to operate, with less injury and complication in treating severe hypospadias.%目的 探讨脱细胞异体真皮基质(AEM)治疗重度小儿尿道下裂的临床疗效.方法 回顾性分析2009年1月至2013年3月河北省邯郸市中心医院小儿外科就诊的重度尿道下裂患儿43例,其中行AEM治疗患儿19例(观察组),行传统尿道成形术患儿24例(对照组),比较2组患儿术后吻合口瘘和尿道狭窄等并发症发生情况及手术时间差异.结果 观察组患儿术后吻合口瘘发生率明显低于对照组[10.5％ (2/19)比41.7％ (10/24)],差异有统计学意义(x2=5.11,P＜0.05);观察组和对照组术后尿道狭窄发生率比较差异无统计学意义[5.3％ (1/19)比25.0％ (6/24)](x2=1.76,P＞0.05);观察组手术时间明显短于对照组[(97±10) min比(121±24) min],差异有统计学意义(P＜0.05).观察组患儿随访期间未发生排异反应,无毛发形成、结石、移植片收缩等并发症发生.结论 与传统尿道成形术相比,AEM治疗重度小儿尿道下裂疗效好、操作简单、创伤小、吻合口瘘发生率低.