儿童尿道下裂修复术后行为改变及其影响因素研究  

Study on behavior changes and it’s influencing factors of children with hypospadias after surgery

作　　者：罗子靖[1] 王磊[1] 高景宇[1] 郝晓东 郑硕 魏洪亮[1] 黄丽华 LUO Zijing;WANG Lei;GAO Jingyu;HAO Xiaodong;ZHENG Shuo;WEI Hongliang;HUANG Lihua(The First Urological Department,The First Affiliated Hospital of Hebei Medical University;Department of Anesthesiology,The 980th Hospital of the Chinese People's Liberation Army Joint Logistic Support Force,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第一医院泌尿外一科 [2]中国人民解放军联勤保障部队第九八〇医院麻醉科,石家庄050000

出　　处：《新疆医科大学学报》2022年第2期208-213,共6页Journal of Xinjiang Medical University

基　　金：河北省医学科学研究重点课题计划项目(20160204)。

摘　　要：目的探讨儿童尿道下裂修复术后不良行为改变(NPOBCs)的发生率及其危险因素。方法前瞻性纳入2018年10月—2019年7月接受尿道下裂手术的177例患儿。术后第14天和30天采用术后行为学问卷(PHBQ)评估患儿NPOBCs。收集的资料包括人口学资料、麻醉细节、手术细节、入院细节、儿童焦虑、儿童气质、疼痛和出现谵妄情况。主要结果为术后第14天和30天NPOBCs的发生率,采用多因素Logistic回归考察与NPOBCs相关的影响因素。结果 60.5%(107/177)的患儿术后14 d出现了NPOBCs,46.5%(79/170)的患儿术后30 d出现了NPOBCs。Logistic回归结果表明年龄<6岁[OR:2.354;95%CI:(1.244~3.478), P=0.004)、情绪化气质(OR:1.112;95%CI:1.011~1.224)和母亲接受过大学教育(OR:2.227;95%CI:1.093~4.536)与术后14 d NPOBCs的发生具有相关性。术后30 d,年龄<6岁是患儿术后发生NPOBCs的影响因素[OR(95%CI):2.056(1.423~3.665),P=0.013]。结论尿道下裂修复手术的儿童在术后出现行为改变,这种改变可能持续数周。除了患儿年龄小和母亲教育程度较高外,情绪化气质也与NPOBCs的发生具有相关性。Objective To determine the incidence of behavioral changes after repair of hypospadias in children and the influencing factors associated with negative postoperative behavioral changes(NPOBCs). Methods 177 children who underwent hypospadias surgery from October 2018 to July 2019 were prospectively included.On the 14 th and 30 th day after operation, the children’s NPOBCs were evaluated by Post-Hospitalization Behavioral Questionnaire(PHBQ). Information were collected including demographic data, details of anesthesia, details of surgery, details of admission,child anxiety, child temperament, pain and delirium. The primary outcome was the incidence of behavioral changes at day 14 and 30 postoperatively. Multivariate logistic regression was used to determine the influencing factors associated with NPOBCs. Results A total of 60.5%(107/177) children had NPOBCs on the 14 th day after surgery, and 46.5%(79/170) children had NPOBCs on the 30 th day after surgery. Logistic regression results indicated that age less than 6 years old(OR=2.354;95%CI 1.244-3.478, P=0.004), emotional temperament(OR=1.112;95%CI 1.011-1.224), and maternal college education(OR=2.227;95%CI 1.093-4.536) were correlated with the occurrence of NPOBCs on the14 th day postoperatively, and age < 6 years old at 30 days after surgery was a risk factor for NPOBCs [OR(95%CI) :2.056(1.423~3.665), P=0.013]. Conclusion Children accepting hypospadias repair have behavioral changes that may last for several weeks. In addition to the younger age of the children and the higher education level of the mother, emotional temperament were also correlated with the occurrence of NPOBCs.

关 键 词：尿道下裂修复术 儿童 术后不良行为改变 

分 类 号：R726.9[医药卫生—儿科]