尿道下裂患儿临床特征及危险因素分析  

Clinical features and pathogenic risk factors of hypospadias in children

作　　者：柳琪[1] 单振潮[1] 梁仁章 苏泽礼[1] 周雪鸿[1] Liu Qi;Shan Zhenchao;Liang Renzhang;Su Zeli;Zhou Xuehong(Department of Pediatric Surgery,General Hospital,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院小儿外科

出　　处：《临床小儿外科杂志》2019年第10期854-858,共5页Journal of Clinical Pediatric Surgery

基　　金：宁夏医科大学校级科研项目(编号:XM2015085)

摘　　要：目的 了解尿道下裂患儿临床特征,探究尿道下裂的致病危险因素,为尿道下裂病因学研究及高危人群的早期干预和治疗提供参考。 方法 回顾性分析2004年1月至2018年6月由宁夏医科大学总医院小儿外科收治的682例先天性尿道下裂患儿作为研究对象,其中单纯性尿道下裂481例(70.53%),合并其他畸形201例(29.47%)。对481例无合并症的先天性尿道下裂患儿及同期住院的500例无先天性尿道下裂患儿的父母进行问卷调查。 结果 682例先天性尿道下裂患儿入院年龄(3.75±2.78)岁,城镇297例(43.55%),乡村385例(56.45%)。682例先天性尿道下裂患儿阴茎头型20例(2.93%),冠状沟型119例(17.45%),阴茎体型316例(46.33%),阴茎阴囊型190例(27.86%),阴囊型30例(4.40%),会阴型7例(1.03%)。201例合并其他畸形患儿中;合并1种畸形180例(89.55%),合并2种畸形15例(7.46%),合并3种畸形6例(2.99%);合并泌尿生殖系统畸形170例(84.58%)[其中隐睾畸形150例(88.24%)],合并心血管系统畸形21例(10.45%),合并肌肉骨骼系统畸形5例(2.49%),合并其他畸形9例(4.48%)。早产(OR=10.60)、低出生体重(OR=3.94)、母亲妊娠期高血压(OR=10.15)、母亲孕期饮食缺乏鱼类(OR=2.53)、父亲生活性接触化学污染物(OR=2.79)是尿道下裂的致病危险因素。 结论 先天性尿道下裂患儿中,尿道下裂阴茎体型最常见,少部分患儿合并先天性畸形,以泌尿生殖系统畸形最为常见,尤其是隐睾畸形;早产、低出生体重、母亲妊娠期高血压、母亲孕期饮食缺乏鱼类、父亲生活性接触化学污染物是尿道下裂的致病危险因素。Objective To understand the composition profile of children with hypospadias and explore the pathogenic risk factors of hypospadias so as to provide rationales for its etiological researches and early intervention and treatment of high-risk groups. Methods From January 2004 to June 2018,clinical data were retrospectively analyzed.There were 481 cases of congenital hypospadias without complication and during the same period 500 hospitalized cases of congenital hypospadias were surveyed through their parents. Results The admission age was (3.75±2.78).There were 297 cases (43.55%) in cities,towns and villages and 385 cases (56.45%) in rural areas.There were penile glans ( n =20,2.93%),coronary sulcus ( n =119,17.45%),penile corpus ( n =316,46.33%),penile scrotum ( n =190,27.86%),scrotal type ( n =30, 4.40%) and perineal type ( n =7,1.03%).There were simple hypospadias ( n =481,70.53%) and other malformations ( n =210,29.47%).The number of deformity was single ( n =180,89.55%),double ( n =15,7.46%) and triple ( n =3,2.99%).There were urogenital malformation ( n =170,84.58%),cryptorchidism ( n =150,88.24%),cardiovascular malformation ( n =21,10.45%),musculoskeletal malformation ( n =5, 2.49%) and other malformations ( n =9,4.48%).Premature birth ( OR =10.60),low birth weight ( OR = 3.94 ),maternal hypertension during pregnancy ( OR =10.15),maternal dietary fish deficiency during pregnancy ( OR =2.53) and paternal exposure to chemical pollutants ( OR =2.79) were risk factors for hypospadias. Conclusion Among children with congenital hypospadias,penile corpus is the most common and few are complicated with congenital genitourinary malformations,especially cryptorchidism.Premature birth,low birth weight,hypertension during pregnancy,maternal dietary fish deficiency during pregnancy and chemical contamination during paternal daily life are the risk factors for hypospadias.

关 键 词：尿道下裂 疾病特征 危险因素 

分 类 号：R726.9[医药卫生—儿科] R695[医药卫生—临床医学]