最大尿流率变化在男童生殖器硬化性苔藓样变治疗中的临床意义OA北大核心
Significance of changes in maximum urinary flow rate in boys with genital lichen sclerosus
目的 总结男童生殖器硬化性苔藓样变(genital lichen sclerosus,GLS)的临床资料,探讨最大尿流率在GLS中的临床意义.方法 回顾性分析2020年4月至2021年6月成都市妇女儿童中心医院泌尿外科收治的41例临床诊断生殖器硬化性苔藓样变患儿行手术治疗前后的临床资料.按照有无排尿困难分为排尿困难组(n=16)和无排尿困难组(n=25);根据术前是否使用激素分为术前使用激素组(n=11)和术前未使用激素组(n=30);根据术后是否使用激素分为术后使用激素组(n=6)和术后未使用激素组(n=35);根据GLS是否累及尿道口分为累及尿道口组(n=4)和未累及尿道口组(n=37).记录各组患儿术前、术后最大尿流率情况,对各组间最大尿流率进行比较.结果 41例GLS患儿术前最大尿流率(10.88±4.26)mL/s与术后1个月最大尿流率(14.44±4.02)mL/s、术后3个月最大尿流率(16.84±2.69)mL/s、术后6个月最大尿流率(18.28±3.76)mUs、术后12个月最大尿流率(17.60±2.57)mL/s相比,差异均有统计学意义(P＜0.05).其中术前最大尿流率异常21例,术后1个月最大尿流率异常6例,术后3个月、术后6个月及术后12个月均无一例最大尿流率异常;与术前未使用激素组相比,术前使用激素组术后1个月最大尿流率正常例数明显减少[63.6％(7/11)比93.1％(27/29)],但差异无统计学意义(x2=3.366,P＞0.05);与术后未使用激素组相比,术后使用激素组术后1个月最大尿流率正常例数明显减少[16.7％(1/6)比97.1％(33/34)],差异有统计学意义(x2=19.931,P＜0.05);与未累及尿道口组相比,累及尿道口组术后1个月最大尿流率正常例数明显减少[0％(0/4)比94.4％(34/36)],差异有统计学意义(P＜0.05).结论 手术治疗可以改善GLS患儿术后最大尿流率.术前使用糖皮质激素乳膏可能不会改善患儿术后最大尿流率,但可作为最大尿流率异常患儿术后辅助治疗手段.最大尿流率可作为GLS患儿排尿功能的重要参考指标之一.
Objective To summarize the clinical data with genital lichen sclerosus(GLS)and explore the significance of maximum urinary flow rate in its diagnosis and management.Methods This retrospective study analyzed clinical data from 41 boys diagnosed with GLS and treated surgically at the Department of Urology,Chengdu Women's and Children's Central Hospital between April 2020 and June 2021.Patients were grouped by urinary difficulty(urinary difficulty group,n=16;no urinary difficulty group,n=25),preoperative corticosteroid use(preoperative corticosteroid group,n=11;no preoperative corticosteroid group,n=30),postoperative cortico-steroid use(postoperative corticosteroid group,n=6;no postoperative corticosteroid group,n=35),and urethral meatus involvement(involvement group,n=4;no involvement group,n=37).Preoperative and postoperative maximum urinary flow rates were recorded and compared among groups.Results A total of 41 cases met patho-logical diagnostic criteria.Maximum urinary flow rate significantly improved from preoperative(10.88±4.26)mL/s to 1 month(14.44±4.02)mL/s,3 months(16.84±2.69)mL/s,6 months(18.28±3.76)mL/s,and 12 months(17.60±2.57)mL/s postoperatively(P＜0.05).Preoperatively,21 patients had abnormal maximum urinary flow rate,which decreased to 6 cases at 1 month postoperatively and resolved completely at 3,6,and 12 months.The preoperative corticosteroid group showed no significant difference in normalized maximum urinary flow rates at 1 month postoperatively compared to the non-corticosteroid group[63.6％(7/11)vs.93.1％(27/29),x2=3.366,P＞0.05].The postoperative corticosteroid group had significantly fewer cases of normalized maximum urinary flow rates at 1 month compared to the non-corticosteroid group[16.7％(1/6)vs.97.1％(33/34),x2=19.931,P＜0.05].Similarly,the urethral meatus involvement group showed fewer normalized maximum urinary flow rate cases at 1 month postoperatively compared to the non-involvement group[0.0％(0/4)vs.94.4％(34/36),P＜0.05].Conclusions Surgical treatment improves postoperative maximum urine flow rate in boys with GLS.Preoperative use of corticosteroid ointments may not improve postoperative maximum urinary flow rate but can serve as an adjunct therapy for patients with abnormal maximum urinary flow rates.Maximum urinary flow rate can be considered an important reference indicator for assessing voiding function in children with GLS.
赵兴;邓常开;彭强;陈月娇;朱俊杰;张昊东;张炜
电子科技大学医学院附属妇女儿童中心医院 成都市妇女儿童中心医院小儿外科,成都 610017电子科技大学医学院附属妇女儿童中心医院 成都市妇女儿童中心医院小儿外科,成都 610017电子科技大学医学院附属妇女儿童中心医院 成都市妇女儿童中心医院小儿外科,成都 610017电子科技大学医学院附属妇女儿童中心医院 成都市妇女儿童中心医院小儿外科,成都 610017电子科技大学医学院附属妇女儿童中心医院 成都市妇女儿童中心医院小儿外科,成都 610017电子科技大学医学院附属妇女儿童中心医院 成都市妇女儿童中心医院小儿外科,成都 610017电子科技大学医学院附属妇女儿童中心医院 成都市妇女儿童中心医院小儿外科,成都 610017
硬化性苔藓样变尿流率外科手术儿童
Lichen SclerosusUrinary Flow RateSurgical Procedures,OperativeChild
《临床小儿外科杂志》 2025 (1)
39-44,6
成都市医学科研项目(2019017) Chengdu Medical Research Project(2019017)
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