包皮平均微血管密度与尿道下裂严重程度及术后近期并发症的相关性研究

Mean microvessel density of the prepuce and its relationship with the severity of hypospadias and early postoperative complications

目的:通过研究尿道下裂包皮平均微血管密度(mMVD),了解其特点及其与尿道下裂严重程度及术后近期并发症的关系。方法:研究组(n=60)为尿道下裂患儿,对照组(n=14)为同年龄段包茎患儿,术中裁剪并留存患儿背侧多余包皮,利用免疫组化的方法显示包皮微血管并计算mMV。术后对行Snodgrass术患儿进行随访。结果:重度尿道下裂mMVD明显低于轻度尿道下裂及对照组。对照组mMVD的中位数为21.8。随访组中高密度组(mMVD≥21.8)并发症的发生率明显低于低密度组(mMVD<21.8)。结论:重度尿道下裂mMVD明显低于正常儿童。尿道下裂越严重,mMVD越低。尿道下裂mMVD越低术后并发症的发生率越高。mMVD值21.8可作为临床评估手术预后的一个参考指标。

Objective:To investigate the mean preputial microvessel density(mMVD)and features of hypospadias and their relationship with the severity and early postoperative complications of the disease.Methods:Sixty children with hypospadias and another 14 age-matching ones with phimosis(the control group)underwent penile curvature correction,Snodgrass procedure or staged surgery,the excessive dorsal foreskin trimmed and retained.We determined the mMVD in the prepuce tissue of the patients by immunohistochemistry,and followed up those treated by Snodgrass procedure.Results:The mMVD was significantly lower in the patients with severe hypospadias than in those with mild hypospadias and the controls(15.51±3.53 vs 19.27±4.42 and 22.09±6.15,P<0.05),with a median of 21.8 in the control group.The incidence of postoperative complications was obviously lower in the high mMVD(≥21.8)than in the low mMVD(<21.8)group.Conclusion:The preputial mMVD is significantly lower in patients with severe hypospadias than in normal children,decreasing in a severity-dependent manner.The lower the preputial mMVD,the higher the incidence rate of postoperative complications.The preputial mMVD of 21.8 can be used as a reference index for evaluating the prognosis of surgery clinically.