兒童陰莖金屬螺母嵌頓1例報告并文獻病例復習

ABSTRACT：ObjectiveTo explore methods about how to treat penile foreign body incarceration，so as to provide reference for clinical treatment of such cases.MethodsThe 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.ResultsA 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.ConclusionSince 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.

摘要：目的探討總結(jié)陰莖嵌頓的處理方法，為臨床處理此類情況提供參考。方法報告華中科技大學同濟醫(yī)學院附屬同濟醫(yī)院小兒外科收治的1例金屬異物陰莖嵌頓患兒的診治經(jīng)過，并檢索相關(guān)中英文文獻，總結(jié)陰莖嵌頓的治療方法及效果。結(jié)果11歲患兒陰莖根部螺母嵌頓10余天，陰莖遠端暗紅腫脹、局部表皮脫落滲液。使用鋼絲鋸將螺母切割后取下，未對陰莖造成二次損傷，術(shù)后恢復良好，無排尿困難等功能障礙。共檢索到陰莖嵌頓相關(guān)中英文文獻79篇，包括184例陰莖嵌頓患者。治療方法包括放血消腫后直接取下、各種器械切割后取下以及陰莖皮膚脫套等手術(shù)治療。結(jié)論陰莖嵌頓是一種罕見急診病癥，早期處理可以避免并發(fā)癥發(fā)生，及時治療患者預后良好。陰莖嵌頓入異物的處理方法很多，各類方法各有優(yōu)缺點，應綜合評估患者情況后選擇合適的方法，或從簡單到復雜的操作開始嘗試。

關(guān)鍵詞：金屬異物；陰莖異物嵌頓；陰莖損傷

中圖分類號：R697.15" " " " "文獻標志碼：A" " " " " DOI：10.3969/j.issn.1009-8291.2025.04.011

陰莖嵌頓臨床較少見，自1755年GAULTIER首次報道以來，可查到的文獻報道不足100篇[1]。成年人中自發(fā)行為造成的陰莖嵌頓

大多是為了追求性刺激、增加性快感，少數(shù)因為精神疾病；兒童和青少年多因為好奇、性快感等。陰莖嵌頓患者常急診入院，如無相關(guān)經(jīng)驗，臨床處理較棘手。本文介紹1例11歲陰莖嵌頓患兒的診療經(jīng)過，并查閱分析國內(nèi)外關(guān)于陰莖嵌頓的相關(guān)文獻，總結(jié)該疾病的診治經(jīng)驗?！?br>