摘要
目的探讨尿道成形术治疗儿童尿道下裂的临床疗效及影响因素。方法回顾性分析2015年5月至2019年5月于南京医科大学附属儿童医院行尿道成形术治疗的216例尿道下裂患儿的临床资料,统计手术成功率。收集患儿年龄、阴茎头直径、阴茎下曲程度、尿道下裂类型、手术方法、尿道缺损长度、尿道修补材料、合并畸形、术后切口感染等临床资料,采用多因素Logistic回归分析探讨影响尿道下裂患儿尿道成形术成功率的危险因素。结果 216例尿道下裂患儿均行尿道成形术,手术成功率为85.65%(185/216)。多因素Logistic回归分析结果显示,年龄≥5岁、阴茎头直径≤1.2 cm、后型尿道下裂、尿道缺损长度>3 mm、术后切口感染均是影响尿道下裂患儿尿道成形术成功率的独立危险因素(均P<0.05)。结论年龄、阴茎头直径、尿道下裂类型、尿道缺损长度、术后切口感染均会影响尿道下裂患儿尿道下裂成形术的成功率,应尽量在学龄前完成手术,根据患儿实际病情选择合适的手术方案和尿道修补材料,并加强围术期管理,以提高手术成功率。
Objective To investigate the clinical efficacy and influencing factors of urethroplasty for children with hypospadias.Method The clinical data of 216 children with hypospadias who underwent various urethroplasty in Children's Hospital of Nanjing Medical University from May 2015 to May 2019 were retrospectively analyzed.The success rate of surgery was statistically analyzed.The clinical data of age,diameter of glans,degree of penile curvature,type of hypospadias,surgical methods,length of urethra defect,urethral repair material,malformation and postoperative wound infection were collected,and multivariate Logistic regression analysis was used to investigate the risk factors affecting the success rate of urethroplasty in children with hypospadias.Result All 216 children with hypospadias underwent urethroplasty,and the success rate of operation was 85.65%(185/216).Multivariate Logistic regression analysis showed that age≥5 years old,diameter of glans≤1.2 cm,post-type hypospadias,urethral defect length>3 mm and postoperative wound infection were independent risk factors for the success rate of urethroplasty in children with hypospadias(all P<0.05).Conclusion Age,diameter of glans,hypospadias type,urethral defect length,and postoperative incision infection all affect the success rate of hypospadias in children with hypospadias.Surgery should be completed before school age,the appropriate surgical plan and urethral repair materials should be selected according to the actual condition of the children,and perioperative management should be strengthened to improve the success rate of surgery.
作者
吴云
周静
金成
Wu Yun;Zhou Jing;Jin Cheng(Department of Urology,Children's Hospital of Nanjing Medical University,Nanjing 210001,China)
出处
《中国医学前沿杂志（电子版）》
2020年第6期125-128,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
尿道下裂
尿道成形术
尿道缺损
尿道修补
成功率
影响因素
Hypospadias
Urethroplasty
Urethral defect
Urethral repair
Success rate
Influencing factor
