儿童阴茎金属螺母嵌顿1例报告并文献病例复习

Pediatric penile incarceration by metal screw nut: a case report and literature review

摘要

目的 探讨总结阴茎嵌顿的处理方法，为临床处理此类情况提供参考。方法 报告华中科技大学同济医学院附属同济医院小儿外科收治的1例金属异物阴茎嵌顿患儿的诊治经过，并检索相关中英文文献，总结阴茎嵌顿的治疗方法及效果。结果 11岁患儿阴茎根部螺母嵌顿10余天，阴茎远端暗红肿胀、局部表皮脱落渗液。使用钢丝锯将螺母切割后取下，未对阴茎造成二次损伤，术后恢复良好，无排尿困难等功能障碍。共检索到阴茎嵌顿相关中英文文献79篇，包括184例阴茎嵌顿患者。治疗方法包括放血消肿后直接取下、各种器械切割后取下以及阴茎皮肤脱套等手术治疗。结论 阴茎嵌顿是一种罕见急诊病症，早期处理可以避免并发症发生，及时治疗患者预后良好。阴茎嵌顿入异物的处理方法很多，各类方法各有优缺点，应综合评估患者情况后选择合适的方法，或从简单到复杂的操作开始尝试。

Abstract

Objective To explore methods about how to treat penile foreign body incarceration, so as to provide reference for clinical treatment of such cases. Methods The diagnosis and treatment of a patient with penile metal foreign body incarceration from the Department of Pediatric Surgery of Tongji Hospital was analyzed, relevant Chinese and English literature were retrieved, and treatment methods and outcomes were summarized. Results A 11-year-old boy came to our hospital with a screw nut incarcerated around the penis for over 10 days, the distal penis dark red swelling, local epidermis exfoliation oozing. A wire saw was used to cut and remove the incarcerated object. The patient recovered well, with no secondary damage to the penis, and no dysfunctions like dysuria. The search of the Chinese and English databases obtained a total of 79 penile incarceration-related papers involving 184 cases. Treatment methods included direct removal after bloodletting for detumescence, removal after cutting with various instruments, and penis skin degloving. Conclusion Since penile incarceration is a rare emergency, early treatment can avoid complications with good prognosis. Methods dealing with penile foreign body incarceration have both pros and cons. Therefore, selection of the appropriate methods needs comprehensive evaluation, or follows the order of simple-to-complex operations.

关键词

金属异物 / 阴茎异物嵌顿 / 阴茎损伤

Key words

metal foreign body / penile incarceration / penile injury

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