儿童尿道板和龟头直径比例与尿道成形术后发生并发症的相关性  

Correlation between the ratio of urethral plate to glans and complications after urethroplasty

作　　者：彭潜龙[1] 田稳[1] 聂有能 李创业 赵夭望[1] Peng Qianlong;Tian Wen;Nie Youneng;Li Chuangye;Zhao Yaowang(Department of Urology,Hunan Children's Hospital,Changsha 410000,China)

机构地区：[1]湖南省儿童医院泌尿外科,长沙410000

出　　处：《国际泌尿系统杂志》2022年第3期527-531,共5页International Journal of Urology and Nephrology

基　　金：湖南省卫生健康委科研计划项目 (20200748)。

摘　　要：目的探讨尿道板和龟头直径比例与尿道成形术后发生并发症的相关性。方法选择2015年3月至2016年4月在本院接受尿道板纵切卷管(TIP)尿道成形术治疗的258例患儿。根据患儿术后是否发生并发症分为并发症组(34例)和对照组(221例),比较两组患儿的临床资料、尿道板直径、龟头直径等资料,采用多因素logistic回归方程分析影响患儿术后发生并发症的危险因素;绘制受试者工作特征(ROC)曲线分析尿道板和龟头直径比例在早期评估尿道成形术后发生并发症中的预测价值。结果有3例患儿失访。并发症组的尿道板直径、龟头直径、尿道板/龟头直径(U/G)指标低于对照组,而尿道板位置的百分比高于对照组,差异均有统计学意义(均P<0.05);多因素logistic回归分析结果显示,尿道板远端位置(OR=0.168,95%CI:0.050~0.566)、尿道板直径(OR=0.782,95%CI:0.625~0.979)、U/G(OR=0.001,95%CI:0.000~0.174)是尿道成形术后发生并发症的独立危险因素(均P<0.05);ROC曲线分析显示,尿道板直径、U/G早期预测小儿尿道成形术后发生并发症风险的曲线下面积(AUC)分别为0.659、0.801;尿道板直径预测的灵敏度为88.24%,特异度为42.99%;U/G预测的灵敏度为88.24%,特异度为64.71%。结论U/G能够早期预测小儿尿道成形术后发生并发症的风险,值得临床推广。Objective To explore the relationship between the ratio of urethral plate to glans and complications after urethroplasty.Methods A total of 258 children who received tubularized incised plate urethroplasty(TIP)urethroplasty in our hospital from March 2015 to April 2016 were selected.Children were divided into complication group(34 cases)and control group(221 cases)according to whether complications occurred after surgery.The clinical data,urethral plate width,glans head diameter and other data of the two groups were compared,and the risk factors affecting postoperative complications were analyzed by logistic regression equation.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of the ratio of urethral plate to glans diameter in early evaluation of complications after urethroplasty.Results There were 3 cases of lost follow-up.The indexes of urethral plate diameter,glans diameter and urethral plate/glans diameter(U/G)in the complication group were lower than those in the control group,while the percentage of urethral plate position was higher than that in the control group(all P<0.05).Multivariate logistic regression analysis showed that the distal position of urethral plate(OR=0.168,95%CI:0.050-0.566),urethral plate diameter(OR=0.782,95%CI:0.625-0.979),U/G(OR=0.001,95%CI:0.000-0.174)were independent risk factors for complications after urethroplasty(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of urethral plate diameter and U/G for early prediction of the risk of complications after urethroplasty in children were 0.659 and 0.801,respectively.The sensitivity and specificity of urethral plate diameter were 88.24%and 42.99%respectively.The sensitivity and specificity of U/G ratio were 88.24%and 64.71%respectively.Conclusions U/G can early predict the risk of complications after urethroplasty in children,which is worthy of clinical promotion.

关 键 词：儿童 尿道成形术 尿道板 龟头 

分 类 号：R726.9[医药卫生—儿科]