摘要
目的评估尿道下裂患儿术后远期排尿情况。方法面访和电话随访2001年11月至2013年11月间郑州大学第一附属医院小儿外科收治的尿道下裂术后5年以上且未满18岁的患儿,通过调查问卷和尿流动力学检查,对患儿排尿功能满意度和尿流动力学情况进行评估。结果共与158人取得了联系,获得完成全部问答的有效问卷63例,完成尿流动力学检查39例。患儿年龄6~18岁,平均10.8岁。根据尿道口位置进行分类,远段型20例(31.8%)、中段型31例(49.2%)、近段型12例(19%)。按尿道口到阴茎根部距离,将患儿分为远端型组(37例)和近端型组(26例)。排尿功能满意度调查中,85.7%(54/63)的患儿对排尿功能满意;另有14.3%(9/63)的患儿对排尿功能不满意,主要原因是尿线稍细、尿线不正及尿后滴沥。近端型组有26.9%(7/26)的患儿对排尿功能不满意者,高于远端型组的5.4%(2/37),组间比较,差异有统计学意义(P<0.05)。进行尿流动力学检查的患儿,依照尿道下裂严重程度等级分为远段型组(20例)、中段型组(31例)和近段型组(12例),三组最大尿流率分别为(19.68±8.08)ml/s、(14.91±3.92)ml/s和(6.01±0.71)ml/s,平均尿流率分别为(9.58±1.56)ml/s、(8.70±0.71)ml/s和(3.85±0.64)ml/s,排尿时间分别为(18.00±12.17)s、(28.29±11.60)s和(40.50±6.36)s,达峰时间分别为(8.70±4.91)s、(13.50±5.53)s和(18.50±3.54)s,残余尿量分别为(6.25±4.37)ml、(10.43±6.10)ml和(15.30±1.19)ml,最大逼尿肌收缩压分别为(27.50±13.03)cmH2O、(50.29±15.74)cmH2O和(96.50±35.86)cmH2O,上述指标组间比较,差异均有统计学意义(P均<0.05)。结论大部分尿道下裂患儿术后排尿功能良好,尿流动力学可以作为评价患儿排尿功能的一个客观指标。
Objective To evaluate the postoperative long-term urination of children after surgery for hypospadias.Methods From November 2001 to November 2013,face-to-face interviews and telephone follow-ups were conducted among hospitalized children aged under 18 years after over 5 years after hypospadias surgery.The satisfaction extent with urine function and urine flow mechanics were evaluated through questionnaires and urine dynamic tests.Results A total of 158 children were contacted and 63 of them completed valid questionnaires while 39 received urodynamic examinations.The average age was 10.8(6-18)years.Based upon the location of urethral orifice,clinical types were distal(n=20,31.8%),middle(n=31,49.2%)and proximal(n=12,19%).Based upon the position of urethral opening,they were divided into distal(n=37)and proximal(n=26)groups.During a survey on the satisfaction of voiding function,85.7%(54/63)of them were satisfied with voiding function and 14.3%(9/63)were dissatisfied due to a weak steam,irregular lines and trickling.Through comparison,"proximal type group"had a higher proportion of dissatisfaction than that of"distal type group"(26.9%,7/26 vs.5.4%,2/37,P<0.05).Based upon the severity of hypospadias,children with urine dynamic test were divided into three groups of distal type(n=20),middle type(n=31)and proximal type(n=12).For three groups,maximal urinary flow rate was(19.68±8.08)ml/s,(14.91±3.92)ml/s,(6.01±0.71)ml/s,average urine flow rate(9.58±1.56)ml/s,(8.70±0.71)ml/s,(3.85±0.64)ml/s,flow time(18.00±12.17)s,(28.29±11.60)s,(40.50±6.36)s,time to maximal flow(8.70±4.91)s,(13.50±5.53)s,(18.50±3.54)s,residual volume(6.25±4.37)ml,(10.43±6.10)ml,(15.30±1.19)ml and maximal detrusor pressure(27.50±13.03),(50.29±15.74)and(96.50±35.86)cmH2O.And the differences between the above indices were statistically significant(P<0.05).Conclusions Most children have excellent voiding function after hypospadias surgery.And urodynamics may be performed as an objective index for evaluating urinary function of children.
作者
石志康
蒋明珠
赵敏利
张俊杰
张胜利
李泸平
范应中
Shi Zhikang;Jiang Mingzhu;Zhao Minli;Zhang Junjie;Zhang Shengli;Li Luping;Fan Yingzhong(Department of Pediatric Surgery,First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)
出处
《中华小儿外科杂志》
CSCD
北大核心
2020年第9期819-823,共5页
Chinese Journal of Pediatric Surgery
基金
河南省医学科技攻关计划普通项目(201602055)
河南省高等学校重点科研项目计划(18A320046)。
关键词
尿道下裂
尿流动力学检查
问卷调查法
Hypospadias
Urodynamics study
Questionnaire investigation approach
