男性儿童尿道下裂与先天性直肠肛门畸形相关性分析

Correlation of hypospadias with congenital anorectal malformation in male children

目的探究男性儿童尿道下裂患者与先天性直肠肛门畸形的相关性，以获得可靠数据为后续研究提供重要的生物学材料。方法选取来本院接受治疗的男性儿童尿道下裂患儿300例进行回顾性分析，采用病例对照研究，观察尿道下裂与先天性儿童尿道下裂与先天性直肠肛门畸形的关联性。结果尿道下裂与先天性直肠肛门畸形存在关联性（P〈0．05），且男性儿童尿道下裂导致先天性直肠肛门畸形的危险性是无尿道下裂儿童的9．89倍，二者呈正相关，是导致先天性直肠肛门畸形的危险因素（OR=9．00，95% CI：4．49～18．03）；阴茎头型尿道口下裂构成比最大，占47．33％，最低为会阴型，占15．33％。所有类型尿道下裂中会阴型先天性直肠肛门畸形发生率最高68．75％，其次为阴囊型（21．05％）、阴茎型（14．42％）以及阴茎头型（7．75％），相关系数（Ф）=0．353，相关性较好，呈正相关。结论男性儿童尿道下裂与先天性直肠肛门畸形具有一定相关性，且会阴型以及阴囊型尿道下裂患儿发生先天性直肠肛门畸形几率大，故应加大产前诊断力度，保证优生优育。

Objective To explore the correlation of hypospadias with congenital anorectal malformations in male children and to obtain more reliable data and biological materials for further research. Methods 300 male children with hypospadias treated at our hospital were selected and retrospectively analyzed. A case-control study was used to investigate the correlation of hypospadias with congenital anorectal malformation in male children. Results Hypospadias positively correlated with congenital anorectal malformation （P 〈 0.05）; and the risk causing congenital anorectal malformation in male children with hypospadias was risk 9.89 times that in those without （OR=9.00, 95% CI 4.49-18.03）. Balanic hypospadias took the largest proportion, accounting for 47.33%, and perineum type the smallest, accounting for 15.33%. The incidence of congenital anorectal malformation was highest in perineum type hypospadias （68.75%）, and scrotum type （21.05%）, tentum type （14.42%）, and balanic type （7.75%） came next; the correlation coefficient=0.353; the correlation was good and positive. Conclusion Hypospadias positively correlates with congenital anorectal malformation in male children. Children with perineum or scrotum type hypospadias has higher risk in occurring congenital anorectal malformation. There, prenatal diagnosis should be strengthened to guarantee better bearing and rearing.