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Jingdong book

阴茎再造术

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Jingdong book

阴茎再造术

Name: 阴茎再造术
Brand: Jingdong book
SKU: 3117021831
Price: 45.15 USD
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《阴茎再造术(精)》主要由整形外科和泌尿外科医师联袂编撰，并有基础研究、临床心理、影像技术和护理等专业人员参加，它有机结合了相关学科的专业知识，而又突出了各自特点。与其他相关专著相比，这本书不仅系统阐述了相关组织器官的发生发育、影像学检查、各种手术方法及术后处护理等，尤其对作者所完成的阴茎及毗邻结构的原创性研究，并根据研究结果所施行的保留感觉与勃起功能的阴茎再造术作了详尽描述。该书还介绍了阴茎再造术的发展前景，阴茎缺损后的心理变化等，使这本书尤著特色，也使我们对《阴茎再造术(精)》充满期待，我希望它能成为相关专业人员的案头必备参考书。

Author Description

蔡志明，广东揭西人，医学和管理学博士，博士生导师，北京大学深圳医院院长，外科主任医师，泌尿外科研究所所长，广东省男性生殖与遗传重点实验室主任，享受国务院特殊津贴专家。从事泌尿外科临床与基础研究20余年，承担各级科研项目20余项，其中国家“863”项目2项、“973”项目1项、国家自然科学基金项目4项。发表学术论文100余篇，主编学术著作4部，获得各级科研成果奖12项。
朱辉，湖北武汉人，医学硕士，研究生导师，北京大学深圳医院主任医师，整形外科主任。国际美容外科学会会员，中国性学会性医学专业委员会常委，广东省医学会整形外科学分会委员，深圳市医学会整形美容专业委员会副主委。从事整形外科20余年，留美多年，近年专注于外生殖器整形再造和性别畸形的临床与基础研究。在国内外专业杂志发表论文数十篇，主编、参编学术著作9部，承担数项科研课题，获多项省、市科技成果奖。
桂耀庭，湖北仙桃人，医学博士，北京大学深圳医院研究员，广东省男性生殖与遗传重点实验室副主任。1996～2003年为美国北卡罗莱纳大学和加拿大曼尼托巴大学博士后研究人员。从事生殖医学基础研究20余年，承担各级科研项目10余项，其中国家自然科学基金项目2项，发表学术论文90余篇，其中SQL收录的论文28篇；获得各级科技成果奖6项。

Catalogue

第一章概述
第二章男性外生殖器的生长发育与功能
第一节男性外生殖器的生长发育与调控
第二节男性外生殖器的生长发育异常
第三节阴茎勃起功能
第四节男性外生殖器的组织工程

第三章阴茎再造术的应用解剖
第一节阴茎、阴囊及其毗邻组织的局部解剖学
第二节与保留感觉与勃起功能阴茎再造术相关的解剖学研究
第三节阴茎及其毗邻组织的三维可视化研究

第四章阴茎再造术的临床心理学问题
第一节男性生殖器崇拜文化
第二节应激反应的概念
第三节应激反应的生理变化
第四节应激反应的心理变化
第五节阴茎再造术中的临床心理干预

第五章阴茎再造术的相关影像学检查
第一节超声影像学在阴茎再造术中的应用
第二节阴茎的血管造影
第三节阴茎的磁共振检查

第六章传统阴茎再造术
第一节皮管法阴茎再造术
第二节游离皮瓣法阴茎再造术
第三节带蒂皮瓣阴茎再造术
第四节阴蒂阴茎化手术
第五节阴茎再造术的相关问题

第七章保留感觉与勃起功能的阴茎再造术
第一节手术设计原理及适应证选择
第二节手术方法和操作步骤
第三节术后一般处理及并发症防治
第四节典型病例
第五节保留感觉与勃起功能的阴茎再造术的相关问题

第八章阴茎再造术的围术期护理
第一节术前护理
第二节手术准备及术中配合
第三节术后护理
第四节并发症护理
第五节出院指导及随访
参考文献

Book Abstract

当阴茎勃起时，由于暴力扭曲、打击或粗暴性交，可发生阴茎折断。患者自己可感到局部组织破裂，在受伤的瞬间常有响声和剧痛，勃起的阴茎随即松软。因海绵体出血及白膜破裂而形成皮下血肿，甚至出现休克，晚期由于瘢痕挛缩使阴茎变形，引起勃起障碍。如果暴力直接作用于阴茎根部，发生阴茎移位，造成阴茎脱位。阴茎脱位后，可以被挤到阴囊根部、下腹部或大腿根部的皮下，经常合并尿道损伤。
阴茎绞窄多数是由于性方式或者精神失常，有时候由于恶作剧，用线、橡皮筋或者金属环套在阴茎上，引起阴茎的循环障碍，绞窄远端发生水肿、肿胀。绞窄物常嵌入肿胀的组织中，形成恶性循环，终至阴茎坏死。
阴茎离断包括阴茎切断或阴茎被牲畜咬伤致使阴茎部分缺损。阴茎严重损伤，未及时治疗，晚期可影响排尿及性功能。
按照伤口类型，阴茎损伤可以分为开放性创伤和闭合性创伤两大类，这两类的发病原因各有不同。
1.开放性阴茎损伤：多指由于外界原因造成的阴茎损伤，如阴茎在遭受锐性外力，如交通事故、爆炸、塌方、切割、斧砍等各种直接暴力作用下，或阴茎在勃起状态下突遇意外，如坠床、扭曲等，而造成阴茎破裂或断裂性损伤。
2.闭合性损伤：阴茎在遭受钝性外力的作用下，形成阴茎皮下、海绵体或龟头血肿；或阴茎在包皮内断裂；或环状异物造成阴茎绞窄。
从阴茎损伤的外部因素来看，主要有四类：
1.物理性因素：外界的电磁或者机械损伤比较多见。
2.化学性因素：大多见于意外伤害，由电烧伤或腐蚀性很强的化合物造成阴茎的损伤。
3.生物因素：如动物撕咬，从文献报道来看，家畜咬伤依然是阴茎缺损的主要因素。近年多见为妻子对发生不恰当性关系丈夫的恶性惩罚。
4.人为因素：在中世纪以前，因为社会等级不同，阉人是常见的阴茎缺损的对象。
5.医源性因素：现代社会中，因为治疗原因，比如阴茎癌、严重性病或其他严重感染，如坏疽而被迫进行的“医源性切除”，是出现阴茎残缺的主要因素。
阴茎损伤通常伴有尿道损伤，所以尿道的修复和功能重建往往是治疗的关键环节。
所谓的阴茎再造术，是指因为各种原因导致阴茎完全缺损以后，采用手术方式再造阴茎，以患者具有良好的排尿和射精功能为目的。这种重建手术不光需要重建尿道，而且需要重新建立海绵体，需要恢复阴茎的勃起功能，因此无论从理论还是技术角度，其难度都是可想而知的。这个手术已经成为整形外科、泌尿外科最具挑战性的手术之一。
另外一个不容忽视的是，部分阴茎畸形也可能需要实施阴茎再造。阴茎畸形种类繁多，其中少见的包括双阴茎（图1-4）、阴茎弯曲（图1-5）、先天性无阴茎（图1-6）、两性畸形（图1-7）、阴茎阴囊转位（图1-8）等，其中对于部分阴茎严重畸形的患者，也需要实行阴茎重建手术。

Introduction

阴茎是男性标志性器官，具有排尿和排精两种主要功能，其对繁衍后代、家庭幸福和夫妻关系和谐稳定具有特殊意义，因此，自古以来人们称阴茎为男性“命根”。
阴茎因外伤性缺损、肿瘤或性病切除、先天性小阴茎小睾丸综合征，以及近数十年来发展的变性手术都需要进行阴茎再造。要造就一个形态逼真、功能完善、有接近正常勃起和感觉功能的阴茎，需要经过多年甚至数十年的研究、改进和创新，才能完成这项任务。
1936年Bargoras首创腹部皮管法进行阴茎再造，Morales和宋儒耀（1956年）应用下腹壁皮瓣或大腿斜形皮管进行阴茎再造，从20世纪30-70年代，应用皮管法进行阴茎再造，需多次手术，费时1年以上，上述是传统的阴茎再造方法。随着显微外科的发展，上海九院张涤生院士等首先用前臂皮瓣游离移植再造阴茎，随后，应用下腹部岛状皮瓣移植再造阴茎，脐旁岛状皮瓣移植再造阴茎，带双血管蒂的髂骨嵴岛状瓣、阴股沟皮瓣、股前外侧皮瓣、肩胛皮瓣、背阔肌肌皮瓣、足背皮瓣及腓骨骨皮瓣再造阴茎等，各种方法相继出现。为使再造阴茎具有足够的长度，并具备感觉和勃起功能，不少临床学家作了有益探索，如本书作者蔡志明、朱辉等作了30具（60侧）会阴部尸解观察研究认为：完全切断阴茎浅悬韧带（漏斗韧带）和深悬韧带（悬韧带）不会影响阴茎功能，并在龙道畴等的实践基础上，通过对阴茎大部分缺损病例，在全部切断减悬韧带和深悬韧带后，分离部分海绵体脚在耻骨下支上的附着，可以使再造阴茎获得更足够的长度。
《阴茎再造术》主要由整形外科和泌尿外科医师联袂编撰，并有基础研究、临床心理、影像技术和护理等专业人员参加，它有机结合了相关学科的专业知识，而又突出了各自特点。与其他相关专著相比，这本书不仅系统阐述了相关组织器官的发生发育、影像学检查、各种手术方法及术后处护理等，尤其对作者所完成的阴茎及毗邻结构的原创性研究，并根据研究结果所施行的保留感觉与勃起功能的阴茎再造术作了详尽描述。该书还介绍了阴茎再造术的发展前景，阴茎缺损后的心理变化等，使这本书尤著特色，也使我们对《阴茎再造术》充满期待，我希望它能成为相关专业人员的案头必备参考书。

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Jingdong book

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