Abstract: Background　Nearly 20 to 40 years,the morbidity of hypospadias worldwide increases year by year,and the epidemiological survey and research in Shaanxi area is lacking domestically.Objective　To understand the epidemiological characteristics of hypospadias in Shaanxi,and to provide reference for the prevention of hypospadias in this region.Methods　429 hospitalized patients with hypospadias in Department of Urology of Xijing Hospital from September 2000 to December 2015 were retrospectively selected as research objects.The clinical data of patients were analyzed,and the admission age distribution of the patients,the year of birth-number of cases distribution,the years of hospitalization-number of cases distribution,distribution of urban and rural areas,geographical distribution,clinical classification distribution and other combination of malformations situation were described.Results　The admission age of patients was（1.33-36.75）,the average admission age was（8.50±6.17）;P25=4.08,P50=6.08,P75=11.50.Among the 429 patients,the birth year was from 1971 to 2012,only 1 case was born in 1971,and the number of cases that born before 1991 every year was below 10,of which no patient was born between 1972 and 1978,and in 1981，1985;since 1992,the number of cases had a wave-like increasing,reached its peak in 2005,and then began to decline gradually;in 2000,there were 3 hospitalized cases,the number of hospitalized cases per year from 2000 to 2015 was in a wave-like rising tendency,and reached its peak in 2015,and then began to decline gradually.Of the 429 patients,145（33.8%） were in urban area and 284（66.2%） in rural area;and 289（67.4%） in Guanzhong area,including 129（44.6%） in Xi’an,73（25.3%） in Weinan,63（21.8%） in Xianyang,21（7.3%） in Baoji,and 3（1.0%） in Tongchuan;and 72（16.8%） in northern Shaanxi,including 38（52.8%） in Yulin and 34（47.2%） in Yan’an;and 68（15.8%） in southern Shaanxi,including 26（38.2%） in Hanzhong,23（33.8%） in Shaangluo and 19（28.0%） in Ankang.429 cases were treated with traditional clinical classification:367 cases（85.5%） of body of penis type,50（11.7%） of balanic type,9（2.1%） of scrotal type and 3（0.7%） of perineum type;clinical classification of DUCKETT:50（11.6%） cases of anterior segment type,of which 41（82.0%） with coronal sulcus type and 9（18.0%） with balanic type;217 cases（50.6%） of middle segment type;and 162 cases（37.8%） of posterior segment type,of which 151（93.2%） of penis-scrotum type,8（4.9%） of scrotal type and 3（1.9%） of perineal type.Of the 429 patients,379（88.3%） had simple hypospadias and 50（11.7%） had combination of other malformations;of which 40（80.0%） were combined with one kind of deformity,8（16.0%） were combined with two kinds of deformities,2（4.0%） were combined with three kinds of deformities;38（76.0%） were combined with genitourinary abnormalities 〔of which 34 cases（89.5%） with cryptorchidism deformity〕,9（18.0%） were combined with cardiovascular malformation,4（8.0%） were combined with musculoskeletal malformation and 7（14.0%） with other diseases.Conclusion　The morbidity rate of hypospadias in Shaanxi area is in an increasing tendency from 2000 to 2015,the morbidity rate in rural area is higher than that in urban area,and the morbidity rate in Guanzhong area is relatively high.The most common type of hypospadias is body of penis type,small part of hypospadias patients are combined with other malformations,and the most common is the combination with genitourinary system malformations,especially cryptorchidism malformation,and congenital heart disease is the most common one in the combination with cardiovascular system malformations.

Key words: Hypospadias, Epidemiology, Shaanxi

摘要： 背景　近20~40年来，世界范围内尿道下裂发病率逐年上升，国内缺乏陕西地区流行病学调查研究。目的　了解陕西地区尿道下裂流行病学特征，为本地区尿道下裂的预防提供参考依据。方法　回顾性选取2000年9月—2015年12月在西京医院泌尿外科住院的尿道下裂患者429例为研究对象。分析患者临床资料，描述患者的入院年龄分布、出生年份-病例数分布、住院年份-病例数分布、城乡分布、地域分布、临床分型分布及合并其他畸形情况。结果　患者入院年龄（1.33~36.75）岁，平均入院年龄（8.50±6.17）岁；P25=4.08岁，P50=6.08岁，P75=11.50岁。429例患者中，出生年份1971—2012年，仅1例出生于1971年，1991年以前每年出生的病例数均在10例以下，其中无1972—1978年及1981年、1985年出生的患者，自1992年开始，病例数呈波浪式上升，于2005年达最高峰，而后下降；2000年住院的有3例，2000—2015年每年住院的病例数呈波浪式上升，2015年达最高峰，而后下降。429例患者中，城镇145例（33.8%），乡村284例（66.2%）；关中地区289例（67.4%），其中西安市129例（44.6%）、渭南市73例（25.3%）、咸阳市63例（21.8%）、宝鸡市21例（7.3%）、铜川市3例（1.0%）；陕北地区72例（16.8%），其中榆林市38例（52.8%）、延安市34例（47.2%）；陕南地区68例（15.8%），其中汉中市26例（38.2%）、商洛市23例（33.8%）、安康市19例（28.0%）。429例患者采用传统临床分型：阴茎体型367例（85.5%），阴茎头型50例（11.7%），阴囊型9例（2.1%），会阴型3例（0.7%）；采用DUCKETT临床分型：前段型50例（11.6%），其中冠状沟型41例（82.0%）、阴茎头型9例（18.0%）；中段型217例（50.6%）；后段型162例（37.8%），其中阴茎阴囊型151例（93.2%）、阴囊型8例（4.9%）、会阴型3例（1.9%）。429例患者中，单纯尿道下裂379例（88.3%），合并其他畸形50例（11.7%）；其中合并1种畸形40例（80.0%），合并2种畸形8例（16.0%），合并3种畸形2例（4.0%）；合并泌尿生殖系统畸形38例（76.0%）〔其中隐睾畸形34例（89.5%）〕，合并心血管系统畸形9例（18.0%），合并肌肉骨骼系统畸形4例（8.0%），其他7例（14.0%）。结论　2000—2015年陕西地区尿道下裂发病率总体上呈上升趋势，乡村发病率高于城镇，关中地区发病率较高。尿道下裂阴茎体型最常见，少部分尿道下裂患者合并其他畸形，最常见的是合并泌尿生殖系统畸形，尤其是隐睾畸形，合并心血管系统畸形中先天性心脏病最常见。

关键词: 尿道下裂, 流行病学, 陕西