摘要
目的探讨隐睾患儿手术年龄变化趋势及相关影响因素,提高对隐睾合理治疗年龄的认识。方法回顾性分析郑州大学第一附属医院2012年3月至2017年12月接受手术治疗的1915例隐睾患儿的临床资料。收集所有入选患儿的人口统计学数据、合并阴茎发育异常情况、手术时间及其他影响因素等资料。采用t检验及多元线性回归分析对影响隐睾手术时机的相关因素进行分析。结果1915例隐睾患儿年龄0.3~14.0岁,平均4.49岁;农村1511例(78.9%),城市404例(21.1%);单侧隐睾1412例(73.7%),双侧隐睾503例(26.3%);合并尿道下裂61例(3.2%),合并隐匿性阴茎13例(0.7%),小阴茎18例(0.9%),其他阴茎发育异常、隐睾并发育不良或者萎缩268例(14.0%);术后复发或下降不全53例(2.8%);1474例(77.0%)患儿1.5岁以后接受手术治疗。民族(t=1.340,P=0.181)、医疗保险类型(t=1.365,P=0.172),合并阴茎发育异常(t=1.627,P=0.104)对手术年龄没有影响。多因素分析结果提示,腹腔内隐睾(t=3.027,P=0.003)、合并斜疝/鞘膜积液(t=5.025,P=0.000)、城乡差异(t=3.626,P=0.000),侧别(t=4.341,P=0.000)明显影响手术时机。结论参加研究的1915例隐睾患儿中,1.5岁内手术的隐睾患者诊治率明显偏低。隐睾的早期诊断和治疗关系到睾丸的发育和生育能力,应在临床工作引起足够重视。
ObjectiveTo investigate the changing trend of the age of cryptorchidism and the related influencing factors, and to improve the understanding of the reasonable age of cryptorchidism treatment.MethodsThe clinical data of 1 915 cryptorchidism children undergoing surgical treatment in the First Affiliated Hospital of Zhengzhou University from March 2012 to December 2017 were retrospectively analyzed. The demographic data, genitourinary abnormalities, age at first orchidopexy and other factors of the selected children were recorded. T test and multiple linear regression analysis were used to analyze the factors affecting the operation time of cryptorchidism surgery.ResultsThe 1 915 children with cryptorchidism ranged was 0.3 to 14 years old, the average age was 4.49; there were 1 511 cases (78.9%) in rural areas and 404 cases (21.1%) in cities; unilateral cryptorchidism occurred in 1 412 cases (73.7%), bilateral cryptorchidism in 503 cases (26.3%); there were 61 cases (3.2%) with hypospadias, 13 cases (0.7%) with concealed penis, 18 cases (0.9%) with small penis, and 268 cases (14.0%) with other penile dysplasia, cryptorchidism and dysplasia or atrophy; 53 cases (2.8%) had recurrence or incomplete descent after operation, and 1 474 cases (77.0%) received surgical treatment after 1.5 years old. Ethnic group (t=1.340, P=0.181), medical insurance type (t=1.365, P=0.172) and penile dysplasia (t=1.627, P=0.104) had no effect on the age of operation. Multivariate analysis showed that the time of operation was significantly affected by the intraperitoneal cryptorchidism (t=3.027, P=0.003), oblique hernia/hydrocele (t=5.025, P=0.000), urban-rural difference (t=3.626, P=0.000), and lateral testis (t=4.341, P=0.000).ConclusionsAmong the 1 915 children with cryptorchidism who participated in the study, the rate of cryptorchidism in the age of 1.5 is significantly lower. Early diagnosis and treatment of cryptorchidism is related to testicular development and fertility, which should be paid enough attention in clinical work.
作者
骆艳冰
崔西春
张大
王家祥
Luo Yanbing;Cui Xichun;Zhang Da;Wang Jiaxiang(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用医刊》
2018年第22期10-13,共4页
Chinese Journal of Practical Medicine
关键词
隐睾
睾丸固定术
手术时机
Cryptorchidism
Testicular fixation
Operative timing