文章摘要
刘 禹,郭云飞,汪 俊,朱浩波,马 耿,葛 征,邓永继.阴茎(中间型)尿道下裂Onlay术后并发尿瘘相关因素分析[J].南京医科大学学报,2020,(12):1834~1838
阴茎(中间型)尿道下裂Onlay术后并发尿瘘相关因素分析
Factors affecting the incidence of urethral fistula after operation in middle hypospadias used Onlay island flap urethroplasty
投稿时间:2020-05-13  
DOI:10.7655/NYDXBNS20201218
中文关键词: 尿道下裂  骶麻  多因素分层因素  尿道瘘
英文关键词: hypospadias  sacral anaesthesia  multifactor hierarchical analysis  urethral fistula
基金项目:南京医科大学科技发展基金面上项目(2017NJMU062)
作者单位
刘 禹 南京医科大学附属儿童医院泌尿外科江苏 南京 210008 
郭云飞 南京医科大学附属儿童医院泌尿外科江苏 南京 210008 
汪 俊 南京医科大学附属儿童医院泌尿外科江苏 南京 210008 
朱浩波 南京医科大学附属儿童医院泌尿外科江苏 南京 210008 
马 耿 南京医科大学附属儿童医院泌尿外科江苏 南京 210008 
葛 征 南京医科大学附属儿童医院泌尿外科江苏 南京 210008 
邓永继 南京医科大学附属儿童医院泌尿外科江苏 南京 210008 
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中文摘要:
      目的:探讨在中间型尿道下裂行Onlay术式(加盖包皮岛状皮瓣尿道成形术)中,术后尿道瘘形成的危险因素。方法:对2017年3月—2019年6月,在南京医科大学附属南京儿童医院泌尿外科接受Onlay术式的中间型尿道下裂患者267例,进行了回顾性对比分析。收集的数据包括患儿手术时年龄、体重、手术医师、手术时间、尿道开口位置、尿道缺损长度、矫直方式及麻醉方式(分单纯静吸复合全麻、静吸复合全麻合并骶麻)。并对术后尿道瘘的可能危险因素进行单因素及多因素分析。结果:267例患儿,中位年龄为19个月(5~132个月)。 平均手术时间87.19 min,体重为13.33 kg。通过单因素分析,发现手术年龄(P=0.123)、体重(P=0.155)和缺损距离(P=0.096)与尿道瘘的发生无关。同样,在接受合并骶麻的患儿中,尿道瘘的发生率与单独接受全麻没有显著差异(29.7% vs. 25.8%,P=0.953)。 手术时间(P=0.010)、手术医生(P=0.001)和矫直方法(P=0.003)对其有影响。基于单因素分析结果,进行了多因素分析,发现外科医生(P=0.031)的经验在尿瘘中起重要作用。结论:尿道下裂手术后尿道瘘的发生与麻醉技术、手术年龄、体重、矫直方法、手术时间无关,与手术医生因素相关。
英文摘要:
      Objective:This study aims to investigate the risk factors of urethral fistula after Onlay?island flap urethroplasty for middle hypospadias. Methods:We conducted a retrospective and contrastive analysis which contained patients(n=207)receiving Onlay?island flap urethroplasty for hypospadias from March 2017 to June 2019,in the urology department of Nanjing Children’s Hospital Affiliattd of Nanjing Medical University. The data collected included the age,weight,surgeon,operation time,position of urethral opening,length of urethral defect,straightening method and anesthesia method(general anesthesia,general anesthesia combined with Caudal anesthesia). The possible risk factors of complications were analyzed by single and multiple factors. Results:A total of 267 cases of children conform to the study. The median age was 19 months(5~132 months). The mean operation time was 87.19 min and weight was 13.33 kg. By univariate analysis,we found that the operative age(P=0.123),weight(P=0.155)and defect distance(P=0.096)were not related to the occurrence of urethral fistula after hypospadias. Similarly,the incidence of urethral fistula in children receiving sacral anesthesia was not significantly different from receiving general anesthesia alone(29.7% vs. 25.8%,P=0.953). While the operative time(P=0.010),surgeon (P=0.001)and straighting method(P=0.003) affect it.However,Based on the univariate results,we conducted further multivariate analysis and found that experience of surgeons(P=0.031)plays a key role in urinary fistula. Conclusion:The occurrence of urethral fistula after operation of hypospadias has nothing to do with anesthesia technique,age at operation,weight,straightening method and operation time. but has related to surgeon.
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