摘要
目的探讨不同年龄段隐睾患儿腹腔镜下治疗后性激素变化及影响手术时机的危险因素,提高治疗隐睾患儿的手术效果。方法选择2018年6月到2021年8月于杭州市儿童医院收治的80例隐睾患儿为研究对象,且所有患儿行腹腔镜手术。将6~12个月的26例患儿纳入低龄组,1~2岁的42例患儿纳入中龄组,>2岁的12例患儿纳入超龄组。记录患儿手术资料,检测促卵泡激素(FSH),促黄体生成素(LH)、睾酮(T)水平,Logistic分析影响隐睾患儿手术时机的独立危险因素,ROC曲线分析影响隐睾患儿手术时机因素的诊断价值。结果3组在睾酮水平[低龄组(7.36±1.63)vs(7.48±1.67)ng/ml、中龄组(7.03±1.26)vs(7.11±1.07)ng/ml、超龄组(4.81±1.37)vs(4.92±1.63)ng/ml]、隐匿睾丸容积[低龄组(0.30±0.01)vs(0.32±0.03)cm^(3)、中龄组(0.45±0.14)vs(0.47±0.11)cm^(3)、高龄组(0.45±0.09)vs(0.61±0.08)cm^(3)]、隐匿睾丸最低血流速度[低龄组(3.42±0.87)vs(4.26±0.94)cm/s、中龄组(3.51±0.26)vs(5.69±0.35)cm/s、高龄组(8.41±0.34)vs(23.64±0.19)cm/s]方面均增加;在术中出血量、术后下床时间、切口疼痛时间等方面比较,超龄组>中龄组>低龄组;在FSH、LH方面,低龄组降低,中龄组、超龄组增加(P<0.05)。年龄、家庭收入、初产妇、孕期吸烟或被动吸烟、孕期糖尿病、孕期补充蛋白质是影响隐睾患儿手术时机的独立危险因素,ROC曲线下面积分别为0.884、0.704、0.785、0.842、0.904、0.845,列线图模型及模型区分度验证效果良好,评价区分度的ROC曲线下面积为0.866。结论不同年龄段的隐睾患儿采用腹腔镜下治疗后性激素变化幅度和年龄有关,患儿在年龄、家庭收入、初产妇、孕期吸烟或被动吸烟、孕期糖尿病、孕期未补充蛋白质是影响手术时机的因素。
Objective To explore the changes of sex hormones in children with cryptorchidism of different ages after laparoscopic treatment and the risk factors that affect the timing of surgery,so as to improve the surgical effect of the treatment of children with cryptorchidism.Methods A total of 80 children with cryptorchidism admitted to our hospital from Jun.2018 to Aug.2021 were selected as the study subjects,and all children underwent laparoscopic surgery.Twenty-six children aged 6 to 12 months were included in the younger group,42 children aged 1 to 2 years were included in the middle age group,and 12 children>2 years old were included in the over-age group.Surgical data of the children were recorded,and the levels of follicle-stimulating hormone(FSH),Luteinizing hormone(LH)and Testosterone(T)were detected.Logistic analysis was used to analyze the independent risk factors affecting the timing of operation in children with cryptorchidism,and ROC curve analysis was used to analyze the diagnostic value of factors affecting the timing of operation in children with cryptorchidism.Results The level of T(the younger group(7.36±1.63)vs(7.48±1.67)ng/ml;the middle-age group(7.03±1.26)vs(7.11±1.07)ng/ml;the over-age group(4.81±1.37)vs(4.92±1.63)ng/ml),occult testicular volume(the younger group(0.30±0.01)vs(0.32±0.03)cm^(3);the middle-age group(0.45±0.14)vs(0.47±0.11)cm^(3);the over-age group(0.45±0.09)vs(0.61±0.08)cm^(3))and occult testicular minimum blood flow velocity(the younger group(3.42±0.87)vs(4.26±0.94)cm/s;the middle-age group(3.51±0.26)vs(5.69±0.35)cm/s;the over-age group(8.41±0.34)vs(23.64±0.19)cm/s)increased in all three groups,In terms of intraoperative blood loss,postoperative time to get out of bed,and incision pain time,the over-age group>the middle age group>the younger group;FSH and LH decreased in the young age group and increased in the middle age group and over-age group(P<0.05).Age,family income,primiparas,smoking or passive smoking during pregnancy,gestational diabetes mellitus,and prote
作者
杨俊家
王爱和
李响
Yang Junjia;Wang Aihe;Li Xiang(Department of Pediatric Urology,Hangzhou Children’s Hospital,Hangzhou 310000,China)
出处
《中华内分泌外科杂志》
CAS
2022年第4期497-502,共6页
Chinese Journal of Endocrine Surgery
关键词
隐睾
腹腔镜
性激素
手术时机
Cryptorchidism
Laparoscopy
Sex hormones
Operation timing
