医患双方评价量表在重型尿道下裂分期修复术后随访评估中的应用

Outcome assessments of staged hypospadias repair by using both physician and parental evaluation questionnaires

目的探讨用医患双方评价量表评估重型尿道下裂分期手术后随访结果的应用价值。方法制定"家长满意评价量表"和"医生评价量表",对近5年来本院实施分期手术治疗的重型尿道下裂病例随访资料进行评估。结果本院2011年至2016年获随访的重型尿道下裂患者43例。家长评价各项满意度(满意及非常满意占比)分别为:阴茎整体外观93.0%,勃起时阴茎伸直97.7%,阴茎头形状93.0%,尿道外口位置和形状90.7%,阴茎皮肤外观90.7%,阴茎长度86.0%。医生评价满意度:阴茎整体外观91.4%,勃起时阴茎伸直、阴茎皮肤外观、尿道外口位置均为100.0%,阴茎头形状85.7%,尿道外口形状80.0%。家长与医生评价的阴茎整体外观、勃起时阴茎伸直、阴茎头形状、阴茎皮肤外观、尿道外口位置和形状的对应项目满意度比较,差异均无统计学意义(P值均>0.05)。结论医患双方评价量表能较为客观、全面地评估尿道下裂手术效果。医患双方对重型尿道下裂分期手术后的阴茎整体外观、勃起时阴茎伸直、尿道外口位置、阴茎皮肤外观满意度较高;家长对患儿阴茎长度的满意度较低。

Objective To evaluate the outcomes of severe hypospadias staged repair objectively by u- sing evaluation questionnaires for both physicians and patients. Methods The ＂parental satisfaction question- naire＂ and ＂ physician evaluation scale＂ were used for examing the satisfaction level of severe hypospadias staged repair over the past 5 years. Results A total of 43 cases of severe hypospadias staged repair were fol- lowed up between 2011 and 2016. The parental results （proportion of satisfied and very satisfied cases） were as follows： straightness upon erection was 97. 7%, shape of glans and general satisfaction both 93.0%, position and shape of urethral opening and appearance of penile skin both 90. 7% and penile length 86. 0%. The physi- cian results were as follows ： straightness upon erection, appearance of penile skin, position of urethral opening were all 100. 0%, general satisfaction was 91.4%, shape of glans 85.7% and shape of urethral opening 80.0%. The satisfactions of the corresponding items were not significantly different between parents and physi- cians （ P 〉 0. 05）. Conclusions The evaluation questionnaires from both physicians and parents are objective and comprehensive instruments for assessing the outcomes of hypospadias surgeries. Both physicians and pa- tients are highly satisfied with straightness upon erection, general penis appearance, urethral opening position and penile skin appearance. Penile length has lower parental satisfaction.