1、小儿GM-CDS包皮环扎术,天津佳恒协创医用器材有限公司,包茎是包皮开口狭窄或包皮与阴茎头（龟头）粘连，包皮不能外翻露出龟头。包皮过长是指包皮覆盖全部龟头及尿道口，仍可上翻露出龟头。,包皮过长或包茎使局部难于清洁或无法清洁，易在包皮下积聚污物，形成包皮垢，病源体容易滋生、繁殖，继发感染。包皮垢的慢性刺激和包皮反复炎症，是阴茎癌重要原因。严重的包茎，包皮开口小，排尿时包皮鼓起如球状，使尿流受阻可引起上尿路扩张和肾功能损害。包皮过长或包茎因包皮垢和炎症的刺激常出现局部搔痒，青春期后反复抓痒，易养成手淫的习惯。因此，应早期行包皮环切术。,据普查，80%以上的学龄前儿童有包茎或包皮过长。随着社会上性病
2、流行的日渐增多、公民的卫生意识提高已及广大婴幼儿健康普查的广泛开展，越来越多的家长已意识到包皮过长、包茎的危险性，很多家长都主动要求患儿作包皮环切术。,过去，由于婴幼儿恐惧、不合作的特点，使本来的小手术变得复杂化。传统的小儿包皮环切手术需住院1周以上，手术时间长，手术后要打针、吃药，要反复换药，拆线，术后伤口水肿、疼痛明显，增加了儿童的恐惧感，很难取得他们的合作。对于家长来说传统的手术要花3000元以上。,GM-CDS包皮环扎术是采用一个空心的塑料环套入包皮内，把多余的包皮在塑料环外结扎后剪掉，手术后经塑料环内孔排尿，手术后1014天被结扎的包皮无菌性坏死、被保留的包皮愈合，结扎线与塑料套自动
3、脱落而治愈。,该手术无需住院，手术约5分钟完成，大大缩短了手术时间，手术中出血少（不到1ml）、不用缝针，手术后不用换药、拆线，手术后局部伤口水肿、疼痛少，手术当天即可下床活动，手术后第1天可正常生活、学习（上学）。手术的费用全部约500元左右，是传统手术的六分几之一。,由于该手术无开放性伤口，手术后伤口感染机会极少，术后无须强调消炎治疗，仅在家里用消毒药水冲洗伤口即可，术后第1、2天可适当口服一些消炎药，手术12天后可洗澡。据我们随访观察的资料看，包皮环套术愈合后的伤口比传统手术伤口要光滑、整齐、美观，保留的包皮适中，由于包皮内无结扎线的残留，伤口无疤痕或疤痕极少。,手术的麻醉是很多家长关心
4、的问题，往往认为全身麻醉会影响小儿的智力，其实大可不必。据医学研究和临床资料显示目前使用的全身麻醉药是安全、无副作用的。我们在手术时会根据不同的儿童、不同的年龄选择使用不同的药物、药量和用药方法，对于年龄稍大、能通过术前术中的交流取得合作的儿童可使用局部麻醉或使用适量的镇静药物，而不用全身麻醉。,做手术前应避免感冒、咳嗽等呼吸道疾病，有感冒、咳嗽，或包皮发炎的儿童应先消炎治疗，炎症好转了1周后才能做手术。做手术前要做简单的血、尿常规检查，做手术前6个小时不能吃东西、不能喝水。,手术操作方法,小儿包皮除去环GMCDS,1。打开包装之前洗干净手和生殖器，此时在生殖器未勃起状态下操作。No.1 Be
5、fore unpacking the product and starting the procedure, wash the hands, the penis, and the foreskin thoroughly. Ensure that the penis is not erect.,2。按图2将消毒液在包皮内外部擦好No.2 Rub some alcohol as a disinfectant on the foreskin.(Drawing 2),3。按图3把包皮完全后推No.3 Retract the foreskin all the way.(Drawing 3),4。按图4先
6、选好适当的规格，能达到套在龟头的3分之2的规格为最好，将圆圈推到龟头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 its flow is unobstructed. Too small a ring may injure the glans.(Draw
7、ing 4),5。按图5拉住包皮和圆圈的把手，将后推的包皮圆圈上覆好，此时将包皮那面的肌肉一起拉下来。,No.5 Pull the foreskin back to its original position, so that it entirely covers the plastic ring. The amount of foreskin tissue which will be over the plastic ring varies from child to child. Holding the rings projecting handle securely, roll the
8、childs foreskin forward as far as possible, pinching the foreskin against the handle to hold it securely.(Drawing 5),6。按图6把绑线使劲拉紧而旋转两三次，打个结，然后把绑线的余部除掉。,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 in the plastic ring
9、. 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 the ends of the string.(Oozing will occur if the string is loose.)Trim the loose ends of the string.
10、(Drawing 6),7。按图7把包皮完全整理好之后，将圆圈的把手掉下来。,No.7 Rub some alcohol onto the foreskin again. Break the plastic handle off of the ring.(Drawing 7)Check for the proper passage of urine on a daily basis.,8。按图8绑线系好3天后，把已死去的包皮用手术刀或剪刀除掉。,No.8 If the patient experiences a lot of pain in the constricted foreskin,
11、or if urination is painful, a longitudinal 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，把绑线和圆圈轻轻地抽下来除去。,No.9 On the eight day after the application of the device, cut
12、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 sufficiently moistened, the plastic ring and the dead tissue of the foreskin can be removed during the bathing process.
13、The tissue will be gradually removed while bathing. If required, oral and / or topical antibiotics may be used for the maintenance of hygiene, and analgesics may be used for minor discomfort.,术中结扎图1,术中结扎图2,结扎后图,去掉手柄后图,48小时后图,术后5天图,术后10天图,型 号 选 用 方 法,在未勃起的状态下，用一根线或尺量取冠状沟的周长，据此根据以下列表选择相匹配的CDS环,儿童用产品详细说明,1。规格：13，14，15，18mm (以环内径为准）2。重量：0.9克1.1克3。由内环及手柄构成材质 （acetate celluroid)松紧绳4。包装：塑封纸盒，每箱30个,谢 谢!,
