改良尿道板纵切卷管尿道成形术治疗小儿尿道下裂的临床效果分析

Clinical effect analysis of modified longitudinal urethral plate and coiled tube urethroplasty in the treatment of children with hypospadias

目的探讨改良尿道板纵切卷管尿道成形术(Snodgrass术)治疗小儿尿道下裂(hypospadias,HP)的效果。方法选取2022年3月—2023年3月郑州大学第一附属医院收治的78例HP患儿,按手术方法不同,将采用传统Snodgrass术治疗的39作为对照组,将采用改良式Snodgrass术治疗的39例作为研究组,比较两组的疗效、手术相关指标、疼痛与生活质量评分及并发症。结果研究组治疗后总有效率94.87%,高于对照组的79.49%,差异有统计学意义(χ^(2)=4.129,P=0.042);研究组手术时间、术中出血量、下床时间及住院时间分别为(76.68±10.46)min、(26.78±6.42)mL、(16.32±2.43)h和(7.23±3.56)d,均少于对照组(P<0.05);治疗前两组VAS、WHOQOL-100评分比较无统计学意义(P>0.05);治疗后两组VAS评分均降低,WHOQOL-100评分均升高,且研究组VAS评分(3.17±1.33)分,低于对照组,WHOQOL-100评分(89.65±6.16)分,高于对照组,差异均有统计学意义(P<0.05);研究组并发症发生率[7.69%(3/39)]低于对照组[25.64%(10/39)],差异有统计学意义(P<0.05)。结论针对儿童HP患者实施改良版Snodgrass术,能够有效改善各项手术指标,并且能够缓解疼痛、减少并发症发生率,在提升临床治疗效果、改善患者生活质量方面显示出重要价值。

Objective To investigate the effect of modified longitudinal urethral plate coiled tube urethroplasty(Snodgrass)in the treatment of children with hypospadias(HP).Methods A total of 78 children with HP treated in our hospital from March 2022 to March 2023 were selected.According to different surgical methods,39 patients treated with traditional Snodgrass surgery were selected as the control group,and 39 patients treated with improved Snodgrass surgery were selected as the study group.The therapeutic effect,surgical indexes,pain and quality of life scores and complications were compared between the two groups.Results The total effective rate of the study group was 94.87%,which was higher than that of the control group(79.49%),and the difference was statistically significant(χ^(2)=4.129,P=0.042).The operation time,intraoperative blood loss,getting out of bed time and hospitalization time of the study group were(76.68±10.46)min,(26.78±6.42)mL,(16.32±2.43)h and(7.23±3.56)d,respectively,which were lower than those of the control group(P<0.05).There was no significant difference in VAS and WHOQOL-100 scores between the two groups before treatment(P>0.05).After treatment,VAS score decreased and WHOQOL-100 score increased in both groups.VAS score of the study group(3.17±1.33)was lower than that of the control group,and WHOQOL-100 score(89.65±6.16)was higher than that of the control group,with statistical significance(P<0.05).The incidence of complications in the study group[7.69%(3/39)]was lower than that in the control group[25.64%(10/39)],and the difference was statistically significant(P<0.05).Conclusion The implementation of modified Snodgrass for children with HP can effectively improve various surgical indicators,relieve pain,reduce the incidence of complications,and show important value in enhancing clinical treatment effect and improving patients'quality of life.