改良尿道板纵切卷管尿道成形术治疗尿道下裂患儿的效果及安全性分析

Effect and safety analysis of modified tubularized incised plate urethroplasty in children with hypospadias

目的 研究对尿道下裂患儿实施改良尿道板纵切卷管尿道成形术治疗的临床效果。方法 60例尿道下裂患儿,采用数字分配模式分为对比组和改良组,每组30例。改良组应用改良尿道板纵切卷管尿道成形术治疗,对比组应用传统尿道口基底血管皮瓣尿道成形术治疗。比较两组患儿治疗效果、并发症发生情况、手术指标(手术时间、下床时间、术中出血量、住院时间)及治疗前后生活质量评分、疼痛评分。结果 改良组治疗总有效率93.33%高于对比组的70.00%,差异具有统计学意义(P<0.05)。改良组并发症发生率为3.33%,低于对比组的53.33%,差异具有统计学意义(P<0.05)。改良组手术时间(76.24±12.93)min、下床时间(16.24±2.61)h、住院时间(7.21±3.62)d均短于对比组的(97.93±10.88)min、(24.67±3.55)h、(9.45±2.41)d,术中出血量(26.63±6.72)ml少于对比组的(34.61±7.52)ml,差异具有统计学意义(P<0.05)。治疗后,两组生活质量评分高于本组治疗前,疼痛评分低于本组治疗前,且改良组生活质量评分(91.67±0.67)分高于对比组的(74.22±0.41)分,疼痛评分(1.52±0.34)分低于对比组的(3.62±1.57)分,差异均具有统计学意义(P<0.05)。结论 尿道下裂患儿应用改良尿道板纵切卷管尿道成形术可减轻疼痛,提升生活质量,患儿术后并发症发生率较低。

Objective To study the clinical effect of modified tubularized incised plate urethroplasty in children with hypospadias.Methods A total of 60 children with hypospadias were divided into comparison group and modified group,with 30 cases in each group.The modified group was treated with modified tubularized incised plate urethroplasty,and the comparison group was treated with conventional urethroplasty of urethral orifice base vascular flap.Both groups were compared in terms of therapeutic effect,occurrence of complications,surgical indicators(operative time,off-bed time,intraoperative blood loss,length of hospital stay),quality of life score and pain score before and after treatment.Results The total effective rate of 93.33%in the modified group was higher than that of 70.00%in the comparison group,and the difference was statistically significant(P<0.05).The incidence of complications in the modified group was 3.33%,which was lower than that of 53.33%in the comparison group,and the difference was statistically significant(P<0.05).The modified group had operative time of(76.24±12.93)min,off-bed time of(16.24±2.61)h and length of hospital stay of(7.21±3.62)d,which were shorter than those of(97.93±10.88)min,(24.67±3.55)h and(9.45±2.41)d in the comparison group;the intraoperative blood loss of(26.63±6.72)ml in the modified group was less than that of(34.61±7.52)ml in the comparison group;all the differences were statistically significant(P<0.05).After treatment,the quality of life score in the two groups was higher than that before treatment in this group,and the pain score was lower than that before treatment in this group;the quality of life score of(91.67±0.67)points in the modified group was higher than that of(74.22±0.41)points in the comparison group;the pain score of(1.52±0.34)points in the modified group was lower than that of(3.62±1.57)points in the comparison group;all the differences were statistically significant(P<0.05).Conclusion In children with hypospadias,modified tubularized incised plate urethroplasty can reduce pain and improve quality of life,and the incidence of postoperative complications is low.