目的:探讨不同方法行包皮环切术的临床效果.方法:回顾性分析2008年1月至2011年8月采用不同方法行包皮环切术的临床资料1 247例.其中传统包皮环切术982例、激光袖套状包皮环切术123例、包皮环环扎术142例,并对其手术平均耗时、水肿消退期时间、术后并发症如术后创口出血、术后感染、术后线头反应、术后伤口裂开、再次手术率,进行临床观察比较.结果:传统包皮环切术组的手术时间(26.8±5.9) min及术后水肿消退时间(13.8±4.5)d分别介于激光袖套状包皮环切术组和包皮环环扎术组之间,3组比较差异均有统计学意义(P＜0.05).在术后并发症发生率和再次手术情况方面,传统包皮环切术组分别是0.7％(7/982)和0.2％ (2/982),激光袖套状包皮环切术组分别是4.9％(6/123)和0.8％(1/123),包皮环环扎术组分别是12.9％(16/142)和4.2％(6/142),3组手术方式对比差异也具有统计学意义(P＜0.05),传统包皮环切术组并发症及再次手术的发生率均最小.结论:激光袖套状包皮环切术手术耗时长、术后恢复期长、术后并发症多.包皮环环扎术手术耗时短、术后恢复快、不残留线头、外形美观,但感染率高,一旦感染伤口易裂开,必须控制感染后重新清创缝合.传统包皮环切术比较包皮环环扎术手术耗时、术后水肿消退期虽长,但术后并发症少,再次手术率低,较为安全可靠.%Objective To access the clinical effects of three different circumcision procedures. Methods A retrospective analysis was conducted of all patients who received circumcision in General Hospital of Guangzhou Military Command from January 2008 through August 2011. Of all the 1247 patients, nine hundred and eighty-two received traditional circumcision (traditional circumcision group, Group A), one hundred and twenty-three received laser sleeve circumcision (laser sleeve circumcision group, Group B), and 142 received plastibell circumcision (plastibell circumcision group, Group C). Specific data regarding average operation time, edema subsidise time, postoperative complicaions (including wound bleeding, infection, lint reaction, wound burst, etc) and reoperation rate were recorded and analysed. Results The average operation time and edema subsidise time of Group A were (26.8 + 5.9)min and (13.8 ± 4.5)d, respectively. Both of which were significantly lower than that of Group B (P ＜ 0.05) and higher than Group C (P ＜ 0.05). As far as postoperative complications rate and reoperation rate were concerned, patients who received traditional circumcision (Group A) tended to have the lowest chance to get postoperative complications (7/982, 0.7%) or to have reoperation (2/982, 0.2%), as compared with the rates of (6/123, 4.9%) and (1/123, 0.8%) in Group B and (16/142, 12.9%) and (6/142, 4.2% ) in Group C. The three groups differ significantly in complication and reoperation rate when pairwise compared (P ＜ 0.05). Conclusion Laser sleeve circumcision needs more operation time as well as longer recovery time, and has a higher probability in developing postoperative complications. Plastibell circumcision has advantages of less operation time and shorter recovery time, no lint residual, and nice shaping, while has a disadvantage of higher infection rate. Once infected, the wounds tend to crack easily, and need debridement suture after infection controlled. In comparison with plastibell circumcision, traditional circumcision, which is more time-consuming in operation and edema subsidise, has a lower risk in developing complication and reoperation, that makes which a relatively safe and reliable choice.
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