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目的:回顾性分析规范手术操作程序的尿道板纵切卷管尿道成形术(tubularized incised plate urethroplasty，TIP)治疗原发性尿道下裂的临床效果以及发生术后并发症的相关因素。方法:共447例患儿纳入研究，年龄5～176个月，中位年龄21个月。18个月龄以下患儿175例(39%)，18个月龄以上患儿272例(61%)。其中阴茎远段型160例(36%)，阴茎中段型216例(48%)，阴茎近段型71例(16%)。高年资医生组实施手术281例(63%)，低年资医生组实施手术166例(37%)。分析各个解剖类型之间术后并发症的发生差异。运用卡方检验分析比较不同年龄段患儿的术后并发症差异以及不同年资医生运用规范化手术操作的术后并发症差异。将患儿年龄段、解剖因素、医生年资等纳入方程，运用二分类logistic回归分析影响施行手术成功率的相关因素。结果:447例患儿手术成功(无尿道皮肤瘘、尿道狭窄、尿道憩室、阴茎下弯、阴茎隐匿)386例(86%)。不同解剖类型的患儿手术并发症发生率不同，阴茎远段型5%(8例)较低，和另外两型相比差异有统计学意义(n P＝0.000)。不同年资医生手术的术后并发症发生率比较，差异均无统计学意义(n P>0.05)；不同年龄段患儿的术后并发症比较，对于不同解剖类型患儿的术后并发症发生率差异也均无统计学意义(n P>0.05)。二分类logistic回归分析结果显示，不同年资医生手术成功率n OR值为0.902(0.508～1.604)，差异没有统计学意义(n P＝0.726)。n 结论:规范手术操作程序的TIP术适用各个年龄段不伴严重阴茎下弯的原发性尿道下裂患儿，治疗阴茎远段型手术成功率较高，且便于训练小儿泌尿外科医生。“,”Objective:To explore the efficacies and outcomes of standardized tubularized incised plate (TIP) urethroplasty for pediatric hypospadias.Methods:A total of 447 hypospadias children with a median age of 21(5-176) months were recruited.There were 175 cases (39%) aged under 18 months and 272 cases (61%) aged above 18 months.The clinical types were distal (n n=160, 36%), middle (n n=216, 48%) and proximal (n n=71, 16%). There were 281 cases (63%) in senior group and 166 cases (37%) in junior group.The differences of postoperative complications among different anatomical types were analyzed.Chi-square test was employed for analyzing and comparing the differences of postoperative complications among children of different age groups and the differences of postoperative complications among physicians of different seniority using standardized surgical procedures.Age, anatomical factors and seniority of physicians were included.And binary logistic regression analysis was performed for analyzing the influencing factors of operative success rate.n Results:All operations were performed successfully.There was no postoperative onset of urethral skin fistula, urethral stricture, urethral diverticulum, penile curvature or penile occultation.The incidence of surgical complications varied among children with different anatomical types.Eight cases (5%) of distal penis type had the lowest level and the difference was statistically significant as compared with another two types (n P=0.000). No significant difference existed in the incidence of postoperative complications among physicians with different seniority (n P>0.05). No significant difference existed in the incidence of postoperative complications among children of different age groups (n P>0.05). Binary logistic regression analysis indicated that operative success rate or value of physicians with different seniority was 0.902 (0.508-1.604) and the difference was not statistically significant (n P=0.726).n Conclusions:TIP is effective for children with hypospadias of all ages.The success rate of distal operation is relatively high and it is convenient for training pediatric urologists.