隐匿阴茎的诊断与整复矫治(1)
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【摘要】 目的 通过对58例隐匿性阴茎患儿的诊断与治疗，了解外科手术对儿童隐匿性阴茎治疗的有效性。方法 本院2005年6月至2009年6月治疗58例隐匿性阴茎患儿。年龄2~15岁。阴茎长度0.8~2.8 cm。据阴茎体外显程度分为轻、中、重度，其中轻度9例，中度26例，重度23例，并据其不同程度的解剖特征采取相应的手术矫治。结果 58例患儿切口均一期愈合，无明显并发症，术后阴茎比术前延长2~3 cm。随访3个月~2年，均解除包茎，排尿正常，阴茎外观亦满意。3例肥胖患儿因耻骨前脂肪大量堆积，短期内影响外观，但随着阴茎生长发育，形态逐渐恢复正常。结论 根据不同的病因和病理改变，进行正确的诊断和鉴别诊断是儿童隐匿性阴茎手术治疗的重要前提。选择适合的手术治疗方法，可明显延长患儿阴茎长度，改善排尿症状和阴茎外观。
【关键词】 隐匿性阴茎；手术治疗；儿童
Diagnosis and Surgical treatment of Concealed penis
LIANG Jie,GUO Xiao-rui,WU Zhi-yuan,et al.
Department of Plastic Surgery, Affiliated Hospital of Guangdong Medical College，Zhanjiang524001, China
【Abstract】 Objective To evaluate the effects of surgical treatment for concealed penis from 58 children cases. Methods 58 children with concealed penis were reviewed retrospectivelyin the Department of Plastic Surgery, Affiliated Hospital of Guangdong Medical College from Jun.2005 to Jun.2009.Patients were 2~15 years old.Penis length was0.8~2.8 cm. They were classified as mild 9 cases, moderate in 26,and severe in 23 according to severity. Surgical procedures were selected based on varied anatomical changes in different categories. Results Of all 58patients were primary healing.No notable complications were found.The length of the penises was extended about 2.0~3.5 cm. Followed up 3 months to 2 years，58 children’s phimosis were removed，the micturition were normal；the appearance of penis was also satisfactory after operation. The penis contour was dissatisfactory in 3 obesity patient，but it was ameliorated gradually while growing up. Conclusion The correct diagnosis and differential diagnosis are very important for operative treatment depend on the different etiology and pathologic changes of concealed penis.Suitable operation can extend the length；moreover，ameliorate the symptom of micturition and the appearance of the penis.
【Key words】 Concealed penis；Surgical treatment；Children
隐匿性阴茎是一种阴茎体发育正常而显露异常的疾病，多见于青春期前儿童。随着临床医生近年来对该病重视程度提高，隐匿性阴茎的发病率也呈逐年上升趋势。根据不同的病因和病理改变，进行正确的诊断和鉴别诊断是儿童隐匿性阴茎手术治疗的重要前提。为提高对儿童隐匿性阴茎的诊断和手术治疗，对2005年6月至2009年6月在广东医学院附属医院整形外科住院行隐匿性阴茎手术治疗58例患儿的资料进行总结。
1 资料和方法
1.1 临床资料 本组58例，患儿年龄2~15岁，平均7.5岁，阴茎长度0.8~2.8 cm，平均1.4 cm。据阴茎体外显程度及伴随包茎、包皮口狭窄等的不同分为我们将其分为轻中重三度，其中轻度9例，中度26例，重度23例。主要临床表现为阴茎外观短小，耻骨前方脂肪肥厚，阴茎皮肤仅见包皮堆积，包皮似“鸟嘴”状包住阴茎，与阴茎体不附着。触诊包皮腔空虚扪不到阴茎体，按压包皮根部可显露出发育正常的阴茎体，伴有包茎和阴茎皮肤发育不良，不伴有其他阴茎畸形。合并肥胖者9例，生后即被发现阴茎隐匿畸形 ......
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