隐睾患儿手术年龄变化趋势及相关影响因素分析  

Orchidopexy trends in pediatric population and timing factors associated with orchiopexy： u retrospective single-center study

作　　者：姜大朋[1] 李志星[2] 耿红全[1] 徐卯升[1] 徐国锋[1] 林厚维[1] 方晓亮[1] 贺雷[1] 金龙虎 

机构地区：[1]上海交通大学医学院附属新华医院小儿外科,200092 [2]广西南宁市第一人民医院小儿外科

出　　处：《中华小儿外科杂志》2016年第2期134-138,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的本研究拟分析隐睾患儿临床特点及手术年龄的变化趋势，同时探索影响隐睾手术时机的相关因素。方法回顾性分析上海交通大学医学院附属新华医院2007年1月至2015年10月间接受手术治疗的隐睾患儿。收集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。运用t检验及多元线性回归分析对影响隐睾手术时机相关因素进行分析，P〈0．05为差异有统计学意义。结果共有1607例隐睾患儿被纳入本研究，其中单侧隐睾1449例（90．17％），合并阴茎发育异常的患儿112例（7％），平均手术年龄为39个月，有81％的患儿于1岁后接受手术治疗。民族、医疗保险类型、家庭收入、城乡差异以及隐睾侧别对手术年龄没有影响。多因素分析结果提示：腹腔内型隐睾（t=3．021，P=0．000）、合并阴茎畸形（t=3．916，P=0．000）、父母文化程度（t=3．563，P=0．000）、等待手术时间（t=2．657，P〈0．05）以及获得专业小儿外科医师治疗意见的时间（t=7．751，P=0．000）明显影响手术时机，结果有统计学意义。结论在所研究的隐睾患儿中，大多数患儿的手术年龄在1岁以后。对患儿家长以及非专科医务人员进行隐睾知识的健康教育可能会提前隐睾的手术时机。Objective To explore the trends in surgical timing of cryptorchidism and determine the factors associated with age at surgery. Methods Reviews were conducted for 1607 boys with cryptorchidism undergoing orchidopexy at Xinhua Hospital between January 2007 to October 2015. Patient demographics, genitourinary abnormalities, age at first orchidopexy and other factors were recorded. Multivariate models were used for determining the factors associated with surgical timing. All statistic analyses were performed with a significance value of P^0. 05. Results Among them, 1449 （90. 17%） had unilateral cryptorchidism and 112 （7%） associated genitourinary abnormalities. The median age at first orchidopexy was 39 months. And 81% of them were operated after 1 year of age. Race, insurance type, household income, urban-rural gap and unilateral/bilateral maldescent did not vary with surgical timing （P〉0. 05）. Multivariate analyses showed that several factors were significantly associated with time to surgery： intraabdominal testicular site （t = 3. 021, P = 0. 000）, concomitant penile anomaly （t = 3. 916, P= 0. 000）, parental education level （t = 3. 563, P = 0. 000）, age of receiving advice from pediatric surgeon （t = 7. 751, P = 0. 000） and waiting time for operation （t = 2. 657, P〈0. 05）. Conclusions Many patients with cryptorchidism are operated on after 1 year of age. Improving alertness and education of parents, subspecialists and primary care providers may lead to earlier operations.

关 键 词：隐睾 睾丸 睾丸固定术 

分 类 号：R726.9[医药卫生—儿科]