关键词: 改良加盖岛状皮瓣, 尿道板纵切卷管尿道成形术, 尿道下裂, 预后, 尿道板, 影响因素

Abstract: Objective To explore the efficacy and prognostic independent factors of modified island flap(OIF) and urethroplasty(tip) in the treatment of hypospadias in children.Methods The 164 children with hypospadias analyzed retrospectively were treated from February,2013 to February,2021.They were divided into two groups according to the operation method.82 patients in tip group were treated with tip and 82 patients in OIF group were treated with OIF.The treatment effects of the two groups were compared.Then they were divided into two groups according to the cure condition,namely,the good prognosis group(cured by operation,151 case) and the poor prognosis group(not cured by operation,13 case).Independent factors affecting the prognosis of children were analyzed by binary logistic regression.Results The cure rate of OIF group was 96.34% ,which was higher than that of the tip group(87.8%),and the incidence of postoperative complications in OIF group was 7.32%,which was lower than that of the tip group(23.17%,P<0.05).The operation time in tip group(95.95±12.35) min,which was shorter than that of the OIF group(P<0.05).At the same time,the binary logistic regression analysis showed that the degree of hypospadias and the classification of barcat were the prognostic factors of children with hypospadias.The degree of penis bending,the width of penis head and the method of operation were suspicious factors.Conclusion OIF and tip have good effects in the treatment of hypospadias in children.OIF has a higher success rate,tip has a shorter operation time and fewer postoperative complications.However,the independent factors affecting the prognosis of children are preoperative hypospadias classification and barcat classification.This operation method is not an independent factor affecting the prognosis.

Key words: improved covered island flap, urethroplasty with longitudinal incision of urethral plate and rolling tube；hypospadias, prognosis, urethral plate, influence factor