尿流率在小儿先天性尿道下裂术后尿道狭窄诊断中的应用  

Application of urinary flow rate in the diagnosis of urethral stricture after operation for congenital hypospadias in children

作　　者：刘月月[1] 涂磊[1] 赵夭望[1] 曹敏[1] 杜昱铿[1] Liu Yueyue;Tu Lei;Zhao Yaowang;Cao Min;Du Yukeng(Department of Urology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院泌尿外科,长沙410007

出　　处：《国际泌尿系统杂志》2022年第2期278-282,共5页International Journal of Urology and Nephrology

基　　金：2021年度湖南省卫生健康委科研立项课题(202104052286)。

摘　　要：目的探讨尿流率在小儿先天性尿道下裂手术前后的变化及对术后尿道狭窄的诊断意义。方法回顾性分析本院2016年12月至2018年12月间接受手术治疗的87例先天性尿道下裂患儿的临床资料(研究组),另选择同期非尿路疾病正常男性儿童60例为对照组。比较两组受试儿童的尿路曲线分布情况及手术前后的最大尿流率(Qmax)、平均尿流率(Qavc)及达尿量95%时间(TQmax)检测结果;比较不同年龄段患儿术前及术后的Qmax、Qavc变化,比较尿道狭窄与无尿道狭窄患儿术前及术后的Qmax、Qavc变化。结果研究组的钟形曲线分布比例[58.62%(51/87)]低于对照组[86.67%(52/60)],平台曲线分布比例[29.89%(26/87)]高于对照组[3.33%(2/60)](均P<0.05);研究组术前的Qmax、Qavc均低于对照组(均P<0.05),TQmax长于对照组(P<0.05);研究组所有年龄段患儿术前及术后的Qmax、Qavc均低于对照组(均P<0.05);不同年龄段患儿组内比较显示:各组术后2周的Qmax、Qavc均低于术前(均P<0.05),术后3、6个月的Qmax、Qavc均恢复到术前水平(均P>0.05);不同年龄段患儿组间比较显示:5~7岁组及>7岁组患儿术前、术后2周、术后3个月、术后6个月的Qmax、Qavc均高于≤2岁组、3~4岁组(均P<0.05);>7岁组患儿术前、术后6个月的Qmax、Qavc均高于5~7岁组(均P<0.05);尿道狭窄患儿的平台尿流曲线分布(100%)高于无尿道狭窄患儿[11.69%(8/69)](P<0.05);尿道狭窄组的术后Qmax、Qavc均低于术前(均P<0.05),无尿道狭窄组术后2周、术后3个月Qmax、Qavc均低于术前(均P<0.05),术后6个月恢复到术前水平;尿道狭窄组术后3个月及6个月的Qmax、Qavc均低于无尿道狭窄组(均P<0.05)。结论尿流率检测可为先天性尿道下裂患儿术后尿道狭窄的诊断及治疗提供重要指导依据,提高手术治疗效果。Objective To investigate the changes of urinary flow rate before and after operation in children with congenital hypospadias and its diagnostic significance for urethral stricture.Methods From December 2016 to December 2018,87 children with congenital hypospadias who underwent surgical treatment in our hospital from December 2016 to December 2018 were analyzed,and 60 normal male children with non urinary tract diseases in the same period were selected as the control group.The distribution of urinary tract curve and the detection results of maximum urine flow rate(Qmax),mean urine flow rate(Qavc)and 95%urine volume(TQmax)were compared between the two groups.The changes of Qmax and Qavc before and after operation in children of different age groups were compared,and the changes of Qmax and Qavc before and after operation in children with urethral stricture and children without urethral stricture were compared.Results The proportion of bell curve distribution in the study group(58.62%)was lower than that in the control group(86.67%),the proportion of platform curve(29.89%)was higher than that in the control group(3.33%),there were significantly differences(all P<0.05);the Qmax and Qavc in the study group were lower than those in the control group,and the TQmax was longer than that in the control group(all P<0.05);Qmax and Qavc in all age groups were lower than those in the control group(all P<0.05).Intra group comparison of children of different ages:Qmax and Qavc were lower than those before operation at 2 weeks after operation(all P<0.05),and Qmax and Qavc recovered to the preoperative level at 3 months and 6 months after operation(all P>0.05);comparison among groups of children of different ages:Qmax and Qavc in 5-7 years old group and>7 years old group were higher than those in≤2 years old group and 3-4 years old group(all P<0.05);>Qmax and Qavc in 7-year-old group were higher than those in 5-7 years old group(all P<0.05);the plateau urinary flow curve of children with urethral stricture was higher than that o

关 键 词：尿道下裂 儿童 尿道狭窄 尿流率 

分 类 号：R726.9[医药卫生—儿科]