简介：摘要目的探讨横裁包皮带蒂岛状皮瓣尿道成形术(DUCKETT术)一期修复合并阴茎下曲的先天性尿道下裂的优点及提高疗效的措施.方法采用DUCKETT术式一期修复尿道下裂４１例作为研究组,另随机选取３４例使用膀胱粘膜带尿道术治疗尿道下裂的患者,作为对照组.比较两组患者术后疗效.结果研究组中４１例患者一期治愈３２例;７例术后出现尿道瘘,３例尿道狭窄,均经尿道扩张术治愈,人均手术(１．２±０．３)次.所有病例均获随访０．５－６年,排尿通畅,外观满意.对照组３４例患者５例一期修复成功,１４例术后出现尿道瘘,８例尿道狭窄,人均手术(２．２±０．５)次,两组比较可知,研究组修复效果明显比对照组好,差异有统计学意义(P＜０．０５),人均手术次数也较对照组少,差异有统计学意义(P＜０．０５).结论DUCKETT术一期治疗合并阴茎下曲的小儿尿道下裂,具有取材方便,皮瓣成活率高,术后并发症少,外形美观等优点,适宜的手术方式、精细的手术技巧及恰当的围手术期处理为提高手术疗效的关键因素.关键词尿道下裂;阴茎下曲;DUCKETT术;小儿AbstractObjectiveToinvestigatethetransversepreputialbeltpedicleislandflapurethraformingtechnique(DUCKETToperation)onestagerepairwithpenilecurvatureofcongenitalhypospadiasadvantagesandenhancetheeffectivenessofmeasures．Methods４１casesofonestagerepairofhypospadiasDUCKETToperationasstudygroupandanotherrandomlyselected３４casesofbladdermucosawithurethralsurgeryforthetreatmentofhypospadiaspatients,ascontrolgroup．Comparethetwogroupsofpatientswithpostoperativeefficacy．Resultsinthestudygroup,４１caseswerecured,３２caseswerecured,７casesofurethralfistula,３casesofurethralstricture,urethraldilatationwascured,percapitaoperation(１．２＋０．３)．Allcaseswerefollowedupfor０．５－６years,theurinationwassmooth,andtheappearancewassatisfactory．Thecontrolgroupof３４patientswithasuccessfulrepair,１４casesofurethralfistula,８casesofurethralfistula,５casesofurethralstricture,percapitaoperation(２．２＋０．５),twogroupsofcomparison,thestudygroupwassignificantlybetterthanthecontrolgroup,thedifferencewasstatisticallysignificant(P＜０．０５),thenumberofoperationspercapitaislessthanthecontrolgroup,thedifferencewasstatisticallysignificant(P＜０．０５)．ConclusionDUCKETTwereaperiodoftreatmentofcombinedwithpenilecurvaturehypospadiasinchildren,withconvenientmaterial,theflapsurvivalrateishigh,lesspostoperativecomplications,beautifulshape,etc．,theappropriatesurgicalapproach,finesurgicaltechniqueandproperperioperativetreatmentinordekreytwooirmdprovethesurgicaleffectofkeyfactors．hypospadias;penilecurvature;DUCKETTsurgery;childre中图分类号R６９５文献标识码B文章编号１００８－６３１５(２０１５)１２－０９８５－０２