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目的:探讨自由尿流率测定(Uroflowmetry,UFM)在评估尿道下裂尿道成形术后排尿功能的作用。方法:66例因尿道下裂而行尿道成形术后的男性患儿,年龄4.2岁±1.1岁。行Duckett尿道成形术27例、Barcat成形术26例、阴囊中隔皮瓣法13例。术后3个月、6个月行UFM测定,将最大尿流率(Qmax)小于同龄小儿正常值的1个标准差定义为可疑梗阻,小于2个标准差或尿流率曲线为平台状定义为梗阻。对可疑梗阻或梗阻的患儿行尿道镜检或尿道造影以明确梗阻部位。结果:本组患儿48例(72.7%)UFM示无梗阻,随访半年仅2例出现尿道狭窄。11例示可疑梗阻、7例梗阻;经尿道镜检或造影12例明确梗阻部位,1例未发现尿道明显狭窄部位,但经尿道扩张后最大尿流率明显改善,其余5例观察治疗的患儿中,3例于术后6个月出现尿道狭窄。不同术式UFM参数间相比无统计学差异(P>0.05)。结论:UFM是评估尿道下裂尿道成形术后尿道狭窄的一项有价值的指标,能够早期发现尿道狭窄的存在。
Objective: To investigate the role of Uroflowmetry (UFM) in assessing voiding function after hypospadial urethroplasty. Methods: Sixty-six male patients after urethroplasty undergoing hypospadias were aged 4.2 ± 1.1 years old. Duckett urethroplasty in 27 cases, Barcat plasty in 26 cases, scrotal septal flap method in 13 cases. UFM was performed at 3 months and 6 months after operation. One standard deviation of the maximum flow rate (Qmax) less than the normal children of the same age was defined as suspicious obstruction. The mean of less than 2 standard deviations or urine flow rate curve was defined as a platform For obstruction. Suspicious obstruction or obstruction of children underwent urethroscopy or urethroscopy to identify obstruction site. Results: 48 cases (72.7%) of the children with UFM showed no obstruction, only two cases were followed up for 6 months urethral stricture. 11 cases showed suspicious obstruction, 7 cases of obstruction; ureteroscopy or contrast 12 cases of clear obstruction site, 1 case did not find obvious location of urethral stricture, but the maximum urinary flow rate after transurethral dilatation was significantly improved, and the remaining 5 cases observed in children In 3 cases, urethral stricture occurred 6 months after operation. There was no significant difference between different operation UFM parameters (P> 0.05). Conclusions: UFM is a valuable indicator of urethral stenosis after hypospadiac urethroplasty and early detection of urethral stenosis.