前型尿道下裂患儿尿道口前移龟头成形术后尿道功能的评估

摘要

目的 探讨尿道口前移龟头成形术(MAGPI)对前型尿道下裂患儿尿道功能的影响.方法 2008年8月到2011年8月作者收治16例男性前型尿道下裂患儿,年龄2～10岁,平均4岁9个月,其中龟头型2例(12.5％),冠状沟型14例(87.5％)；8例(50.0％)伴轻度阴茎下弯.依据Duckctt报道的手术方法对16例患儿行MAGPI手术治疗.术前术后行尿流率检查.结果 患儿均一次手术获成功.术后2～3个月尿流率检查提示最大尿流率、平均尿流率术前术后比较,均有统计学意义,最大尿流率由术前的(9.5±2.7) mL/s增加到术后(11.6±2.0) mL/s(P=0.022)；平均尿流率(6.2±1.6)mL/s增加到术后(7.7±1.4) mL/s(P =0.009).结论 MAGPI手术方法简单,成功率高,术后无尿道狭窄发生,患儿尿道功能较术前改善,对于合适的前型尿道下裂患儿是一种很好的手术方法.%Objective To explore the influence of meatal advancement and glanuloplasty (MAGPI) on urethral function of anterior hypospadias. Methods Sixteen cases were admitted to our department from August 2008 to August2011, including 2 glandular hypospadias( 12.5%), 14 coronal hypospadias (87.5%), and 8 rf them had mild chordee. The mean age was 4 years and 9 months, ranging from 2 years to 10 years. All 16 cases were treated by MAGPI basing on the surgical measures reported by Duckett. Uroflometry was performed in these cases before and after operation. Results Success of operations was achieved in all 16 patients. We checked the Qmax and Qave in these cases 2 months after the operation, and compared them with those before operation. There was significant difference between preoperative data and postoperative data. The Qmax increased from 9. 5 mL/s to 11. 6 ml/s (P = 0. 022), and the Qave increased from 6. 2 ml/s to 7.7 iruVs (P=0.009). Conclusions MAGPI is a simple procedure with high success rate. The urethral function could be improved after operation, without urethral stricture. MAGPI is a good procedure for the suitable anterior hypospadias patients.