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目的:本研究旨在评估尿道板纵切卷管尿道成形术(tabularized incised plate urethroplasty，TIP)术中缝合Buck’s筋膜作为新尿道第二覆盖层，同时恢复尿道的海绵体完整包绕，在减少尿道下裂并发症中的作用。方法:回顾性分析2016年3月至2018年3月就诊于福建省立医院小儿外科的尿道下裂患儿140例，年龄9～48个月。纳入标准：初次治疗的中段型、远端型尿道下裂不伴或仅伴有轻度的阴茎弯曲(由皮肤、肉膜层、Buck’s筋膜牵拉或者轻度海绵体发育不均衡引起的弯曲)，适用于TIP技术治疗。排除标准：复发性尿道下裂，中重度阴茎弯曲(由于尿道板较短或者中重度海绵体发育不均衡引起的弯曲)，需要分期治疗的病例。患儿均行TIP术治疗，术中均先缝合局部尿道海绵体组织作为新尿道第一覆盖层。根据第二覆盖层的不同分为两组：A组患儿共70例，以Buck’s筋膜作为新尿道第二覆盖层。B组患儿共70例，以阴茎背侧带蒂肉膜瓣(DDF)作为新尿道第二覆盖层，设为对照组。比较两组患儿术后近期并发症发生率。结果:A、B两组患儿各类型尿道下裂所占比例：A组中段型伴轻度阴茎弯曲(57.1%)、中段型(31.4%)、远端型伴轻度阴茎弯曲(5.7%)、远端型(5.7%)；B组中段型伴轻度阴茎弯曲(50%)、中段型(35.7%)、远端型伴轻度阴茎弯曲(8.6%)、远端型(5.7%)。两组患儿尿道下裂各类型构成比之间差异无统计学意义(n P>0.05)。经过1年的随访，A组中尿道下裂并发症的发生率：尿道瘘(2.9%)、尿道狭窄(2.9%)、阴茎头裂开(0)、伤口感染(0)。B组中尿道下裂并发症的发生率：尿道瘘(11.4%)、尿道狭窄(1.4%)、阴茎头裂开(5.7%) 、伤口感染(1.4%)。尿道瘘、阴茎头裂开发生率之间差异具有统计学意义(n P0.05). The follow-up period was up to 1 year. The occurrences of complications were urethrocutaneous stula (2.9%), urethral stricture (2.9%), partial glans dehiscence (0) and wound infection (0) in group A and urethrocutaneous stula (11.4%), urethral stricture (1.4%), partial glans dehiscence (5.7%) and wound infection (1.4%) in group B. The occurrence rates of urethrocutaneous stula and partial glans dehiscence were inter-group statistically significant (n P<0.05).n Conclusions:Buck’s fascia is readily available and requires minimal dissection. It is well-vascularized and thick with excellent tensile strength. Used as the second coverage layer of neourethra TIP urethroplasty, Buck’s fascia may restore complete wrapping of neourethra with corpus spongiosum and regain normal anatomical structures of corpus spongiosum and corpora cavernosa. It is both simple and efficacious for preventing urethrocutaneous stula and partial glans dehiscence.