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小儿阴茎尿道下裂显微手术与传统手术临床效果比较及术后尿动力学差异分析

Comparison of clinical effects between microscopic surgery and conventional surgery in children with penile hypospadias and difference analysis of postoperative urodynamics.

作者信息

Guo Shi-Lei, Zheng Wei, Shi Xiao-Qing, Zhang Bo-Song, Wang Jie

机构信息

Shi-lei Guo, Department of Urology Surgery, Beijing Children's Hospital Affiliated to Capital Medical University Baoding Hospital, Baoding 071000, Hebei, China.

Wei Zheng, Department of Urology Surgery, Beijing Children's Hospital Affiliated to Capital Medical University Baoding Hospital, Baoding 071000, Hebei, China.

出版信息

Pak J Med Sci. 2023 Sep-Oct;39(5):1332-1336. doi: 10.12669/pjms.39.5.6986.

Abstract

OBJECTIVE

To compare and analyze the clinical effects of microscopic surgery and conventional surgery in children with penile hypospadias and the differences in postoperative urodynamic indexes.

METHODS

It was a clinical comparative study. A total of 80 children with penile hypospadias admitted to Beijing Children's Hospital Affiliated to Capital Medical University Baoding Hospital from July 2018 to September 2022 were selected and randomly divided into two group. The experimental group were treated with microscopic urethroplasty, while the control group were treated with traditional urethroplasty. The operative effect, operation time, total intraoperative blood loss, postoperative hospital stay and incidence of surgical complications were compared and analyzed between the two groups. All the children were followed up for two years, and the changes in urodynamic parameters including maximum urine flow rate (Qmax), average urine flow rate (Qavc), urine flow time (FT), peak time (TQmax) and residual urine (PVR) were compared before, two weeks after, six months after and two years after surgery.

RESULTS

The efficacy of the experimental group was significantly higher than that of the control group (p=0.013). The intraoperative blood loss and postoperative hospital stay in the experimental group were significantly better than those in the control group (p=0.000). The incidences of urinary leakage and urethral stricture in the experimental group were lower than those in the control group (p<0.05). The Qmax level in the experimental group was higher than that in the control group at six months and two years after surgery, while the FT level was lower than that of the control group (p<0.05).

CONCLUSION

Microscopic surgery is a method with significant clinical value in the treatment of penile hypospadias.

摘要

目的

比较和分析显微手术与传统手术治疗小儿阴茎下裂的临床效果及术后尿动力学指标的差异。

方法

这是一项临床对照研究。选取2018年7月至2022年9月首都医科大学附属北京儿童医院保定医院收治的80例小儿阴茎下裂患儿,随机分为两组。实验组采用显微尿道成形术治疗,对照组采用传统尿道成形术治疗。比较分析两组的手术效果、手术时间、术中总出血量、术后住院时间及手术并发症发生率。对所有患儿进行两年随访,比较术前、术后两周、术后六个月及术后两年的尿动力学参数变化,包括最大尿流率(Qmax)、平均尿流率(Qavc)、尿流时间(FT)、达峰时间(TQmax)及残余尿量(PVR)。

结果

实验组疗效显著高于对照组(p = 0.013)。实验组术中出血量及术后住院时间均显著优于对照组(p = 0.000)。实验组尿瘘及尿道狭窄发生率低于对照组(p < 0.05)。术后六个月及两年时,实验组Qmax水平高于对照组,而FT水平低于对照组(p < 0.05)。

结论

显微手术是治疗小儿阴茎下裂具有显著临床价值的方法。

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