Zuo Dandan,Long Wangjun,Chen Guifang,et al.Effects of catheters of different sizes on uroflowmetry after Snodgrass surgery in children[J].Journal of Clinical Pediatric Surgery,2024,(10):970-975.[doi:10.3760/cma.j.cn101785-202302025-013]
儿童尿道下裂Snodgrass术后不同型号导尿管对尿流率的影响
- Title:
- Effects of catheters of different sizes on uroflowmetry after Snodgrass surgery in children
- Keywords:
- Hypospadias; Uroflowmetry; Surgical Procedures; Operative; Child
- 摘要:
- 目的 探讨儿童尿道下裂Snodgrass术后不同型号导尿管对尿流率的影响。方法 本研究为回顾性研究, 选取2017年7月至2020年6月在广州医科大学附属广州市妇女儿童医疗中心收治的266例阴茎体型尿道下裂患儿为研究对象, 均采用尿道板纵切卷管尿道成形术 (Snodgrass术)一期修复尿道, 术后根据阴茎发育情况及临床经验选择留置不同型号的导尿管, 并于术后3周拔除。按导尿管型号分为3组:F6组(n=89)、F8组(n=85)及F10组(n=92), 测量并记录术后1个月(T1)、3个月(T2)、6个月(T3)、1年(T4)及2年(T5)的尿流率情况, 包括尿流曲线类型、最大尿流率(maximum flow rate, Qmax)、平均尿流率(average flow rate, Qave)。结果 3组患儿T1时间点Qmax及Qave均最低, 后均随时间的延长而升高。5个不同时间点组内比较显示:F6组Qmax[(6.90±2.73)mL/s、(7.27±2.40)mL/s、(8.62±3.03)mL/s、(9.98±3.08)mL/s、(11.3±3.42)mL/s]、F8组Qmax[(7.19±3.14)mL/s、(7.50±2.88)mL/s、(8.41±2.96)mL/s、(8.97±2.83)mL/s、(10.82±4.45)mL/s]、F10组Qmax[(6.72±2.84)mL/s、(6.87±2.71)mL/s、(8.28±2.91)mL/s、(9.48±2.83)mL/s、(10.95±3.15)mL/s]及F6组Qave[(3.99±1.57)mL/s、(4.46±1.67)mL/s、(5.15±1.88)mL/s、(5.86±1.78)mL/s、(6.47±2.22)mL/s]、F8组Qave[(4.04±1.78)mL/s、(4.14±1.76)mL/s、(4.96±1.78)mL/s、(5.45±1.91)mL/s、(6.28±2.89)mL/s]、F10组Qave[(4.04±1.57)mL/s、(4.29±1.70)mL/s、(5.02±1.80)mL/s、(5.64±1.99)mL/s、(6.84±2.37)mL/s]在术后5个时间点差异均有统计学意义(P＜0.01);经多重比较发现, 3个不同导尿管型号组术后Qmax、Qave在T2与T3、T3与T4、T4与T5之间差异有统计学意义(P＜0.01)。术后尿流曲线类型:T1及T2时间点以平台型为主, 其占比分别为60%(160/266)、55%(145/266), T3、T4及T5时间点以钟型为主, 其占比分别为52%(138/266)、57%(152/266)、64%(172/266);尿流曲线类型在不同时间点的分布差异有统计学意义(P＜0.01);相邻时间点两两比较得出, 尿流曲线类型分布差异在T2、T3间差异有统计学意义(P＜0.05)。结论 对于接受一期Snodgrass手术修复的阴茎体型尿道下裂患儿, 采用不同型号导尿管对术后尿流率无显著影响。
- Abstract:
- Objective To explore the effects of catheters of different sizes on uroflowmetry after Snodgrass surgery in children. Methods From July 2017 to June 2020, retrospective study was performed for 266 children with hypospadias undergoing initial Snodgrass surgery.According to the postoperative size of catheter, they were divided into 3 groups of Fr 6 (n=89), Fr 8 (n=85) and Fr 10 (n=92).All catheters were removed at Week 2 post-operation.Uroflowmetry was examined at Month 1 post-operation (T1), Month 3 post-operation (T2), Month 6 post-operation (T3), Year 1 post-operation (T4) and Year 2 post-operation (T5).And urine flow curve, Qmax (maximum flow rate) and Qave (average flow rate) were recorded. Results Qmax and Qave were both the lowest among three groups at T1 and increased over time.Intragroup comparison showed Qmax{Fr 6[(6.90±2.73), (7.27±2.40), (8.62±3.03), (9.98±3.08), (11.3±3.42) mL/s]vs. Fr 8[(7.19±3.14), (7.50±2.88), (8.41±2.96), (8.97±2.83), (10.82±4.45) mL/s]vs. Fr 10[(6.72±2.84), (6.87±2.71), (8.28±2.91), (9.48±2.83), (10.95±3.15) mL/s]} and Qave{Fr 6[(3.99±1.57), (4.46±1.67), (5.15±1.88), (5.86±1.78), (6.47±2.22) mL/s]vs. Fr 8[(4.04±1.78), (4.14±1.76), (4.96±1.78), (5.45±1.91), (6.28±2.89) mL/s]vs. Fr 10[(4.04±1.57), (4.29±1.70), (5.02±1.80), (5.64±1.99), (6.84±2.37) mL/s]} differed greatly at 5 timepoints (P<0.01), Multiple comparisons revealed that Qmax and Qave were significantly different between T2 and T3 (P<0.01), T3 and T4 (P<0.01) and T4 and T5 (P<0.01).Urine flow curve type indicated that platform curve dominated for 60%(160/266) and 55%(145/266) at T1/2 while bell curve accounted for 52%(138/266), 57%(152/266) and 64%(172/266) at T3/4/5.Ratio of urine flow curve type differed markedly at 5 timepoints (P<0.001), especially between T2 and T3 (P<0.05). Conclusions In children of hypospadias after Snodgrass surgery, postoperative uroflowmetry is not affected by catheters of different sizes.
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备注/Memo
收稿日期:2023-2-16。
基金项目:广东省卫健委适宜推广项目(2023C-TS51)
通讯作者:张锦,Email:502067665@qq.com