摘要目的:探讨尿道下裂患儿术后尿路感染的影响因素，并构建列线图模型。方法:选取2019年1月至2023年3月于邯郸市中心医院和河北省儿童医院进行手术的526例尿道下裂患儿为研究对象，根据随机数字表法将其分为建模组(368例)与验证组(158例)，根据术后是否发生尿路感染将建模组分为未感染组(316例)与感染组(52例)。采用多因素logistic回归分析术后发生尿路感染的影响因素。采用校准曲线、Hosmer-Lemeshow(H-L)检验评估列线图模型预测尿道下裂患儿术后发生尿路感染的校准度；利用受试者工作特征(ROC)曲线评估尿道下裂患儿术后发生尿路感染的效能。结果:感染组与未感染组的年龄、尿道下裂分型、术前阴茎下弯、手术时间、留置导尿时间比较，差异均有统计学意义(均 P<0.05)。多因素logistic回归分析，结果显示年龄、尿道下裂分型、术前阴茎下弯、手术时间、留置导尿时间均为影响术后发生尿路感染的独立危险因素(均 P<0.05)。建模组的ROC曲线下面积(AUC)为0.967(95% CI：0.944～0.983)，校准曲线斜率接近1，H-L检验提示模型预测尿道下裂患儿术后发生尿路感染风险与实际风险有较好的一致性( χ2＝6.283， P＝0.616)。外部验证的AUC为0.973(95% CI：0.951～0.987)，校准曲线斜率均接近1，H-L检验提示模型预测术后发生尿路感染与实际风险有较好的一致性( χ2＝6.881， P＝0.551)。 结论:年龄、尿道下裂分型、术前阴茎下弯、手术时间、留置导尿时间均为影响尿道下裂患儿术后发生尿路感染的独立危险因素。据此构建的列线图模型预测价值较好，可为个体化预防尿道下裂患儿术后发生尿路感染提供参考。

abstractsObjective:To explore the influencing factors of postoperative urinary tract infections in children with hypospadias and construct a column chart model.Methods:A total of 526 children with hypospadias who underwent surgery at Handan Central Hospital and Hebei Children's Hospital from January 2019 to March 2023 were selected as the research objects. They were divided into the modeling group (368 cases) and the validation group (158 cases) according to the random number table method. The modeling groups were divided into the non-infection group (316 cases) and the infection group (52 cases) according to whether urinary tract infection occurred after the operation. Multivariate logistic regression analysis was used to analyze the influencing factors of postoperative urinary tract infection. The calibration curve and Hosmer-Lemeshow (H-L) test were used to evaluate the calibration degree of the nomogram model in predicting postoperative urinary tract infections in children with hypospadias. The efficacy of postoperative urinary tract infection in children with hypospadias was evaluated using the receiver operating characteristic (ROC) curve.Results:There were statistically significant differences in age, type of hypospadias, preoperative penile curvature, operation time, and indwelling catheter time between the infected group and the non-infected group (all P< 0.05). Multivariate logistic regression analysis showed that age, type of hypospadias, preoperative penile curvature, surgical duration, and indwelling catheterization duration were independent risk factors for postoperative urinary tract infections( P<0.05). The validation results of the modeling group showed that the area under the ROC curve (AUC) was 0.967 (95% CI: 0.944-0.983), the calibration curve slope was close to 1, The H-L test indicated that the model's prediction of the risk of urinary tract infection in children with hypospadias after surgery was in good agreement with the actual risk ( χ2=6.283, P=0.616). The AUC for external validation of postoperative urinary tract infection was 0.973 (95% CI: 0.951-0.987) for external validation, and the slope of the calibration curve was close to 1, the H-L test showed that the model predicted good consistency between postoperative urinary tract infection and actual risk ( χ2=6.881, P=0.551). Conclusions:Age, type of hypospadias, preoperative penile curvature, surgical duration, and indwelling catheterization duration are independent risk factors for postoperative urinary tract infections in children with hypospadias. The column chart model constructed based on this has good predictive value for postoperative urinary tract infections in children with hypospadias, and can provide reference for personalized prevention of postoperative urinary tract infections in children with hypospadias.