2岁以下儿童包皮环切术后食管及环切部位润滑预防狭窄

S. Mondal, K. Hasina, Md. Ashraf Ul Huq, Md. Ansar Ali, M. Alam, M. M. Hoque, Jaglul Gaffer Khan, A. Rahman, S. Islam
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引用次数: 1

摘要

导言:全球约有三分之一的男性接受过包皮环切术,但有关该手术安全性的数据相对较少。几个世纪以来,出于医学、宗教和其他一些原因,割礼一直是一种外科手术。包皮环切术是世界上最常见的男孩手术。椎管狭窄是其晚期并发症之一。我们评估了男孩包皮环切术后局部使用润滑剂果冻(凡士林-凡士林)以减少或预防金属狭窄的风险。目的:观察润滑剂的使用效果,确定功能结局,即预防包皮环切术后金属狭窄。材料与方法:采用随机对照试验,对两组2岁以下的男孩采用解剖(套)法行包皮环切术。研究小组的家长被严格要求在三个月内每天早上或每次换尿布后在阴道和包皮环切部位使用凡士林,另一方面,对照组的家长被要求不要在同一部位使用任何润滑剂或局部药物。男孩定期随访,评估金属狭窄,出血和感染。结果:共120名男生完成研究,每组60名。研究组男生无一例发生椎管狭窄,对照组6例(10%)发生椎管狭窄,差异有统计学意义(p < 0.05)。润滑油组包皮环切部位感染1例(0.6%),对照组包皮环切部位感染3例(5%)(p<0.05),出血3例(5.0%),出血6例(10.0%)。结论:基于本研究的结果,使用润滑果冻预防包皮环切术后金属狭窄和其他并发症似乎是合乎逻辑的。DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19528
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Lubrication of Meatus and Circumcision Site for Prevention of Post-circumcision Meatal Stenosis in Children Younger Than Two Years Old
Introduction: Approximately one in three men is circumcised globally, but there are relatively few data on the safety of the procedure1. Circumcision is a surgical procedure performed for centuries for medical, religious and several other reasons. Circumcision is the most common surgical procedure performed in boys through out the world. Meatal stenosis is one of its late complications. We evaluated the topical use of lubricant jelly (Vaseline- petroleum jelly) after circumcision in boys in order to reduce or prevent the risk of meatal stenosis. Objective: To see the effectiveness of use of lubricants and to determine the functional outcome, that is prevention of post circumcision meatal stenosis. Materials and Methods: A randomized control trial was performed, in which two groups of boys younger than two years old underwent circumcision according to dissection (sleeve) method . The parents in the study groups were strictly instructed to use petroleum jelly on the meatus and circumcision site at every morning or after each diaper change where necessary for three months, on the other hand parents in the control group were instructed not to use any lubricants or topical medication on the same site. The boys were followed up regularly and evaluated for meatal stenosis, bleeding and infection. Results: A total of 120 boys, 60 in each group completed the study. None of the boys in the study group develop meatal stenosis , but 6(10%) in the control group develop meatal stenosis ( p < 0.05 ). Infection of the circumcision site was seen in 1 (0.6%) and 3 (5%) children in the lubricant and control groups, respectively (p<0.05) and bleeding was seen in 3 (5.0%) and 6(10.0%) respectively. Conclusions: Based on the findings of this study, it seems logical to use a lubricant jelly for prevention of post circumcision meatal stenosis and other complications. DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19528
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