韓氏小兒包皮環(huán)扎術(shù)

1、小兒GM-CDS包皮環(huán)扎術(shù),天津佳恒協(xié)創(chuàng)醫(yī)用器材有限公司,包莖是包皮開口狹窄或包皮與陰莖頭（龜頭）粘連，包皮不能外翻露出龜頭。包皮過長是指包皮覆蓋全部龜頭及尿道口，仍可上翻露出龜頭。,包皮過長或包莖使局部難于清潔或無法清潔，易在包皮下積聚污物，形成包皮垢，病源體容易滋生、繁殖，繼發(fā)感染。包皮垢的慢性刺激和包皮反復(fù)炎癥，是陰莖癌重要原因。嚴(yán)重的包莖，包皮開口小，排尿時包皮鼓起如球狀，使尿流受阻可引起上尿路擴(kuò)張和腎功能損害。包皮

2、過長或包莖因包皮垢和炎癥的刺激常出現(xiàn)局部搔癢，青春期后反復(fù)抓癢，易養(yǎng)成手淫的習(xí)慣。因此，應(yīng)早期行包皮環(huán)切術(shù)。,據(jù)普查，80%以上的學(xué)齡前兒童有包莖或包皮過長。隨著社會上性病流行的日漸增多、公民的衛(wèi)生意識提高已及廣大嬰幼兒健康普查的廣泛開展，越來越多的家長已意識到包皮過長、包莖的危險性，很多家長都主動要求患兒作包皮環(huán)切術(shù)。,過去，由于嬰幼兒恐懼、不合作的特點(diǎn)，使本來的小手術(shù)變得復(fù)雜化。傳統(tǒng)的小兒包皮環(huán)切手術(shù)需住院1周以上，手術(shù)時間長，手術(shù)

3、后要打針、吃藥，要反復(fù)換藥，拆線，術(shù)后傷口水腫、疼痛明顯，增加了兒童的恐懼感，很難取得他們的合作。對于家長來說傳統(tǒng)的手術(shù)要花3000元以上。,GM-CDS包皮環(huán)扎術(shù)是采用一個空心的塑料環(huán)套入包皮內(nèi)，把多余的包皮在塑料環(huán)外結(jié)扎后剪掉，手術(shù)后經(jīng)塑料環(huán)內(nèi)孔排尿，手術(shù)后10~14天被結(jié)扎的包皮無菌性壞死、被保留的包皮愈合，結(jié)扎線與塑料套自動脫落而治愈。,該手術(shù)無需住院，手術(shù)約5分鐘完成，大大縮短了手術(shù)時間，手術(shù)中出血少（不到1ml）、不用縫針，

4、手術(shù)后不用換藥、拆線，手術(shù)后局部傷口水腫、疼痛少，手術(shù)當(dāng)天即可下床活動，手術(shù)后第1天可正常生活、學(xué)習(xí)（上學(xué)）。手術(shù)的費(fèi)用全部約500元左右，是傳統(tǒng)手術(shù)的六分幾之一。,由于該手術(shù)無開放性傷口，手術(shù)后傷口感染機(jī)會極少，術(shù)后無須強(qiáng)調(diào)消炎治療，僅在家里用消毒藥水沖洗傷口即可，術(shù)后第1、2天可適當(dāng)口服一些消炎藥，手術(shù)1~2天后可洗澡。據(jù)我們隨訪觀察的資料看，包皮環(huán)套術(shù)愈合后的傷口比傳統(tǒng)手術(shù)傷口要光滑、整齊、美觀，保留的包皮適中，由于包皮內(nèi)無結(jié)扎

5、線的殘留，傷口無疤痕或疤痕極少。,手術(shù)的麻醉是很多家長關(guān)心的問題，往往認(rèn)為全身麻醉會影響小兒的智力，其實(shí)大可不必。據(jù)醫(yī)學(xué)研究和臨床資料顯示目前使用的全身麻醉藥是安全、無副作用的。我們在手術(shù)時會根據(jù)不同的兒童、不同的年齡選擇使用不同的藥物、藥量和用藥方法，對于年齡稍大、能通過術(shù)前術(shù)中的交流取得合作的兒童可使用局部麻醉或使用適量的鎮(zhèn)靜藥物，而不用全身麻醉。,做手術(shù)前應(yīng)避免感冒、咳嗽等呼吸道疾病，有感冒、咳嗽，或包皮發(fā)炎的兒童應(yīng)先消炎治療，

6、炎癥好轉(zhuǎn)了1周后才能做手術(shù)。做手術(shù)前要做簡單的血、尿常規(guī)檢查，做手術(shù)前6個小時不能吃東西、不能喝水。,手術(shù)操作方法,小兒包皮除去環(huán)GM－CDS,1。打開包裝之前洗干凈手和生殖器，此時在生殖器未勃起狀態(tài)下操作。No.1 Before unpacking the product and starting the procedure, wash the hands, the penis, and the foreskin thoroug

7、hly. Ensure that the penis is not erect.,2。按圖2將消毒液在包皮內(nèi)外部擦好No.2 Rub some alcohol as a disinfectant on the foreskin.(Drawing 2),3。按圖3把包皮完全后推No.3 Retract the foreskin all the way.(Drawing 3),4。按圖4先選好適當(dāng)?shù)囊?guī)格，能達(dá)到套在龜頭的3分之2

8、的規(guī)格為最好，將圓圈推到龜頭3分之2的部位。No.4 Choose a size of plastic ring which will fit about two-thirds (2/3)of the way over the glans. Carefully push this ring onto the  glans, ensuring that the urinary meatus is centered and i

9、ts flow is unobstructed. Too small a ring may injure the glans.(Drawing 4),5。按圖5拉住包皮和圓圈的把手，將后推的包皮圓圈上覆好，此時將包皮那面的肌肉一起拉下來。,No.5 Pull the foreskin back to its original position, so that it entirely covers the plastic ring. T

10、he amount of foreskin tissue which will be over the plastic ring varies from child to child. Holding the ring's projecting handle securely, roll the child's foreskin forward as far as possible, pinching the fores

11、kin against the handle to hold it securely.(Drawing 5),6。按圖6把綁線使勁拉緊而旋轉(zhuǎn)兩三次，打個結(jié)，然后把綁線的余部除掉。,No.6 With the aid of an assistant, twist string two or three times and make a knot with the string and center it over the groove i

12、n the plastic ring. Tighten the know securely, then make three to four complete loops around the ring. The amount of foreskin tissue to be removed will very from child to child. Twist string two or three times and tie th

13、e ends of the string.(Oozing will occur if the string is loose.)Trim the loose ends of the string.(Drawing 6),7。按圖7把包皮完全整理好之后，將圓圈的把手掉下來。,No.7 Rub some alcohol onto the foreskin again. Break the plastic handle off of the

14、ring.(Drawing 7)Check for the proper passage of urine on a daily basis.,8。按圖8綁線系好3天后，把已死去的包皮用手術(shù)刀或剪刀除掉。,No.8 If the patient experiences a lot of pain in the constricted foreskin, or if urination is painful, a longitudinal

15、 slit should be made in the foreskin up to the string.(Drawing 8)(Ref. generally 36 or 48 hours later from application, foreskin becomes dead tissue as a scab.),9。第8天包皮除掉的部位愈合好之后，把綁線和圓圈輕輕地抽下來除去。,No.9 On the eight day aft

16、er the application of the device, cut and remove the string. Do not worry about any seepage from the site, as this is normal. After eight to ten days, bathe the child, and when the dead tissue of the foreskin has been su

17、fficiently moistened, the plastic ring and the dead tissue of the foreskin can be removed during the bathing process. The tissue will be gradually removed while bathing. If required, oral and / or topical antibiotics may

18、 be used for the maintenance of hygiene, and analgesics may be used for minor discomfort.,術(shù)中結(jié)扎圖1,術(shù)中結(jié)扎圖2,結(jié)扎后圖,去掉手柄后圖,48小時后圖,術(shù)后5天圖,,術(shù)后10天圖,型 號 選 用 方 法,在未勃起的狀態(tài)下，用一根線或尺量取冠狀溝的周長，據(jù)此根據(jù)以下列表選擇相匹配的CDS環(huán),兒童用產(chǎn)品詳細(xì)說明,1。規(guī)格：13，14，15，18mm