年龄对尿道下裂Onlay术后尿瘘发生的影响研究  

Impact of age on complications of hypospadias repair

作　　者：黄立渠 葛征[1] 陆如纲[1] 邓永继[1] 马耿[1] 郭云飞[1] 

机构地区：[1]南京医科大学附属南京儿童医院

出　　处：《临床小儿外科杂志》2015年第6期469-471,共3页Journal of Clinical Pediatric Surgery

基　　金：南京市医学科技发展项目,项目号:YKK12105

摘　　要：目的比较不同年龄组患儿尿道下裂组Onlay术后尿瘘发生情况，探讨最佳手术时间。方法回顾性分析南京医科大学附属南京儿童医院泌尿外科自2009年1月至2012年12月实施尿道下裂Onlay手术后尿瘘的发生情况，对不同年龄组病例术后尿瘘发生率进行统计学分析。结果〈1岁组27例，术后出现尿瘘2例（7．4％）；1～3岁组105例，术后出现尿瘘11例（10．5％）；3—6岁组59例，术后出现尿瘘8例（13．5％），6岁以上组27例，发生尿瘘11例（44．4％）。将四组尿瘘发生率进行卡方检验，差异有统计学意义（P值〈0．01）。结论随着年龄增大，尿道下裂术后尿瘘的发生率增高，1岁以内患儿术后发生尿瘘最少，而麻醉风险及术后恢复情况较大年龄患儿并无明显差异。Objetive Compared the surgical complication rates in children undergoing hypospadias repair across different age ranges, to understand the optimal age to perform hypospadias repair. Methods The records of 218 patients who underwent initial hypospadias repair were reviewed. The complication rates of fistula were analyzed by age group using the chi-square test. Results A total of 218 hypospadias repairs were performed with on-lay urethroplasty from January 2009 to December 2012 by a single surgeon. Of the 218 cases ,2 complications of fistula（ 7.4% ） occurred in the 0 to 1-year-old cohort（ n = 27 ）, 11 （ 10. 5% ） in the 1 to 3- year-old cohort（ n = 105） ,8（ 13.5% ）in the 3 to 6-year-old eohort（n =59） ,11 （44. 4% ） in the more than 6- year-old cohort （n = 27 ）, the complication rates of fistula within each cohort were analyzed using the ehi-square test. We found that the complieationrate of fistula is significantly lower when surgery is performed earlier（ P 〈 0. 01 ）. Conclusions The results of our study have indicated that complications are minimized when hypospa- dias repair is performed when the patient is with in lyear of age. During this period,the risks of anesthesia and the psychological sequela are minimal. Performing hypospadias repair at a later agemay inadvertently place the patient at a greater risk of complications.

关 键 词：尿道下裂 手术后并发症 尿瘘 外科手术 

分 类 号：R726.9[医药卫生—儿科]