本文選題：重慶地區(qū)　切入點(diǎn)：陰莖長(zhǎng)度　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本文通過研究0~16歲男性陰莖、睪丸發(fā)育情況,探討構(gòu)建重慶地區(qū)0~16歲男性陰莖長(zhǎng)度、陰莖直徑、雙側(cè)睪丸大小的生長(zhǎng)發(fā)育參考范圍,繪制不同年齡男性陰莖長(zhǎng)度、陰莖直徑、雙側(cè)睪丸大小生長(zhǎng)發(fā)育的百分位數(shù)曲線,為臨床疾病的診斷和治療提供重要依據(jù)。方法通過分層整群抽樣,對(duì)2607位正常男性兒童青少年進(jìn)行陰莖、睪丸測(cè)量調(diào)查。采用SPSS 22.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)特征描述,計(jì)量資料以中位數(shù)P50表示,各年齡組陰莖長(zhǎng)度、直徑和睪丸體積的比較采用非參數(shù)檢驗(yàn)中的Kruskal-Walliis H檢驗(yàn),P0.05表示差異有統(tǒng)計(jì)學(xué)意義。廣義可加模型采用R軟件中的基于位置、尺度、形狀的廣義可加模型(GAMLSS)軟件包進(jìn)行參考曲線擬合。了解重慶地區(qū)陰莖、睪丸的數(shù)據(jù)特點(diǎn),采用廣義可加模型(GAMLSS)擬合模型,初步探討重慶市0~16歲兒童青少年陰莖大小和睪丸體積的P3、P10、P25、P50、P75、P90、P97的百分位數(shù)曲線。結(jié)果1.重慶地區(qū)兒童青少年陰莖的生長(zhǎng)發(fā)育現(xiàn)狀調(diào)查對(duì)象結(jié)果表2.1及表2.3顯示,本研究共計(jì)16個(gè)年齡分組,共納入2607例,0~16歲年齡組各個(gè)年齡組總體用秩和檢驗(yàn)Kruskal-Walliis H檢驗(yàn)差異有統(tǒng)計(jì)學(xué)意義(P0.01),Kruskal-Walliis H檢驗(yàn)中成對(duì)兩兩比較得出:0歲組和1歲組兩組的陰莖長(zhǎng)度比較差異有統(tǒng)計(jì)學(xué)意義(P0.01),發(fā)育增長(zhǎng)速度最快,為44.60%(圖),達(dá)到整個(gè)生長(zhǎng)發(fā)育的增長(zhǎng)高峰,Kruskal-Walliis H檢驗(yàn)中成對(duì)兩兩比較1~11歲相鄰兩組的陰莖長(zhǎng)度比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);11~16歲相鄰兩組的陰莖長(zhǎng)度比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)由百分位數(shù)圖2.1得出1歲以前陰莖長(zhǎng)度增長(zhǎng)快速,1~11歲組間增長(zhǎng)較緩慢,11歲進(jìn)入快速增長(zhǎng)期,一直持續(xù)到16歲。陰莖直徑結(jié)果顯示,0~16歲年齡組用陰莖直徑各個(gè)年齡組總體用秩和檢驗(yàn)Kruskal-Walliis H檢驗(yàn)差異有統(tǒng)計(jì)學(xué)意義(P0.01),兩兩比較得出:0歲組和1歲兩組的陰莖直徑比較差異有統(tǒng)計(jì)學(xué)意義(P0.01),組內(nèi)兩兩比較1~11歲相鄰兩組的陰莖直徑差異無統(tǒng)計(jì)學(xué)意義(P0.05);11~16歲相鄰兩組的陰莖直徑比較差異有統(tǒng)計(jì)學(xué)意義(P0.01),由百分位數(shù)圖2.3得出1歲以前陰莖長(zhǎng)直徑增長(zhǎng)快速,1~11歲組間增長(zhǎng)較緩慢,11歲進(jìn)入快速增長(zhǎng)期,一直持續(xù)到16歲。陰莖長(zhǎng)度和陰莖直徑發(fā)展一致,同步進(jìn)入青春期。2.重慶地區(qū)睪丸生長(zhǎng)發(fā)育現(xiàn)狀調(diào)查對(duì)象結(jié)果顯示(表2.4),0歲到1歲調(diào)查對(duì)象102例,各個(gè)年齡組左右兩側(cè)睪丸體積總體用秩和檢驗(yàn)Kruskal-Walliis H檢驗(yàn)以及兩組成對(duì)比較來進(jìn)行組間兩兩比較(P0.01),進(jìn)行組內(nèi)兩兩比較,結(jié)果顯示0歲組右側(cè)睪丸體積與1歲比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),;1~10歲組間增長(zhǎng)較緩慢,相鄰兩組差異無統(tǒng)計(jì)學(xué)意義(P0.05);10~16歲差異有統(tǒng)計(jì)學(xué)意義(P0.01),百分位數(shù)圖(圖2.5和圖2.7)其中10歲進(jìn)入快速增長(zhǎng)期,15歲后增長(zhǎng)速度減慢。左側(cè)睪丸結(jié)果顯示與右側(cè)睪丸結(jié)果幾乎一致,3.睪丸與陰莖的關(guān)系Spearman秩相關(guān)檢驗(yàn)結(jié)果顯示(表2.7),陰莖長(zhǎng)度、陰莖直徑與睪丸大小的生長(zhǎng)發(fā)育互為正相關(guān),陰莖長(zhǎng)度與陰莖直徑的Spearman秩相關(guān)系數(shù)為0.93(r=0.93,P0.01);陰莖長(zhǎng)度與右側(cè)睪丸體積的Spearman秩相關(guān)系數(shù)為0.89(r=0.89,P0.01),;陰莖長(zhǎng)度與左側(cè)睪丸體積的Spearman秩相關(guān)系數(shù)為0.89(r=0.89,P0.01);陰莖直徑與右側(cè)睪丸體積的Spearman秩相關(guān)系數(shù)為0.83(r=0.83,P0.01);陰莖直徑與左側(cè)睪丸體積的Spearman秩相關(guān)系數(shù)為0.83(r=0.83,P0.01);左、右側(cè)睪丸體積的Spearman秩相關(guān)系數(shù)是0.99(r=0.99,P0.01)。。結(jié)論陰莖長(zhǎng)度及睪丸體積大小是衡量男性兒童性發(fā)育的重要指標(biāo),與男性性功能和生育功能存在密切聯(lián)系。因此對(duì)其正確,因地制宜的研究非常重要。重慶地區(qū)0~16歲的男性兒童青少年陰莖長(zhǎng)度、陰莖直徑、與年齡三者互為正相關(guān),同時(shí)本研究首次將WHO所推薦的用于兒童生長(zhǎng)發(fā)育的GAMLSS方法運(yùn)用到男性陰莖、睪丸的生長(zhǎng)發(fā)育方面,得到了重慶地區(qū)男性兒童不同年齡組陰莖長(zhǎng)度、直徑,左右側(cè)睪丸體積生長(zhǎng)發(fā)育情況的不同百分位數(shù)值,繪制了以年齡為協(xié)變量的精確百分位數(shù)曲線圖,有利于臨床醫(yī)生更早期發(fā)現(xiàn)陰莖疾病,豐富、擴(kuò)展了對(duì)重慶地區(qū)青春期性器官發(fā)育研究,為學(xué)校衛(wèi)生相關(guān)內(nèi)容的研究提供了科學(xué)依據(jù),為后期更深入的運(yùn)用GAMLSS模型提供了前期的基礎(chǔ)。
[Abstract]:The purpose of this study by 0~16 year old male penis, testis development, construction of Chongqing area 0~16 year old male penis penis length, diameter, growth and development of the reference range of bilateral testicular size, drawn in different age male penis penis length, diameter, percentile size of bilateral testicular growth and development, provide an important basis for clinical diagnosis and treatment disease. Methods by stratified cluster sampling, the penis of 2607 normal male children and adolescents, testis survey data features are described. Using SPSS 22 statistical software, measurement data with median P50 said that in each age group compared with the penis length, diameter and volume of testis Kruskal-Walliis H test nonparametric test. P0.05 said the difference was statistically significant. The generalized additive model based on the location and scale of R software, the shape of the generalized additive model (GAMLSS) software Package reference curve fitting. In the Chongqing region of the penis, testis data characteristics, using generalized additive models (GAMLSS) model, preliminary study of Chongqing city 0~16 year old children and adolescents penis size and testicular volume of P3, P10, P25, P50, P75, P90, P97 percentile curve. The results of growth the development of 1. respondents in Chongqing children's penis in Table 2.1 and Table 2.3 shows the results of this study, a total of 16 age groups, a total of 2607 cases, there was statistical significance in 0~16 age group in all age groups with rank sum test and Kruskal-Walliis H test (P0.01, Kruskal-Walliis) the difference in H test compared with 22 pairs statistical significance at the age of 0 and 1 years old group of penis length difference between two groups (P0.01), the development of the fastest growth rate, 44.60% (Figure), the growth of high growth, Kruskal-Walliis H test in 22 pairs 1~11 at the age of two adjacent penis length was no significant difference (P0.05); there was statistical significance of penis length 11~16 years old two adjacent group differences (P0.01) by percentile of figure 2.1 that 1 years ago the rapid growth of the penis length, the age group of 1~11 between the relatively slow growth of 11 years, entered a period of rapid growth until the age of 16. The diameter of the results showed that the 0~16 age group with the diameter of each age group in general with the rank sum test Kruskal-Walliis H tests were statistically significant (P0.01), 22 compared with statistical significance at the age of 0 1 years group and two groups of penis (P0.01), the difference was not statistically significant the diameter of the differences among groups compared to 22 1~11 years old two adjacent group (P0.05); there was statistical significance between the two groups of adjacent 11~16 (P0.01), the diameter of the difference by percentile of figure 2.3 that 1 years before the penis length diameter rapid growth The 1~11 age group, among the relatively slow growth of 11 years, entered a period of rapid growth, until 16 years old. The length and diameter of the penis penis development, synchronous puberty in Chongqing area.2. survey results showed that the growth status of the testis (Table 2.4), 0 to 1 years old 102 subjects of different age groups on both sides the overall volume of testis with rank sum test Kruskal-Walliis H test and two for comparison comparison between the 22 groups (P0.01), were compared in 22 groups. Results showed that there was a statistically significant 0 year old and 1 year old group right testicular volume difference (P0.05), 1~10; age group between the relatively slow growth, no significant difference two groups of adjacent (P0.05); 10~16 was statistically significant differences in age (P0.01), percentile chart (Figure 2.5 and figure 2.7) in which 10 year old entered a period of rapid growth, the growth rate slowed down after 15 years. The results showed that the left testis and right testis results almost Consistent relationship between Spearman rank correlation test results of 3. testis and penis showed (table 2.7), penis, penis and testis size growth are positive correlation, Spearman rank correlation coefficient of penis length and diameter of penis was 0.93 (r=0.93, P0.01); Spearman rank correlation coefficient of penis length and right testis volume 0.89 (r=0.89, P0.01), Spearman rank correlation coefficient; penis length and left testicular volume was 0.89 (r=0.89, P0.01); Spearman rank correlation coefficient and diameter of the right testis volume was 0.83 (r=0.83, P0.01); Spearman rank correlation coefficient and diameter of the left testicular volume was 0.83 (r=0.83, P0.01 left, 0.99); Spearman rank correlation coefficient of right testis volume (r=0.99, P0.01). Conclusion the penis length and testicular volume is an important measure of male sexual development of children, there are close and male sexual function and reproductive function Contact. So the correct, very important to the study of Chongqing area. The 0~16 year old male adolescent penis, penis, and age three are positive correlation, at the same time, this study is the first to recommend WHO GAMLSS method for the growth of children with growth and development of male penis, testis, get the male children in Chongqing area in different age groups of penis length, diameter, different percentile side testicular volume growth, plotted with age as covariate precise percentile curves, help clinicians more early detection of disease of penis, rich, extends the study on the development of adolescent sexual organs in Chongqing area the research provides a scientific basis for school health related content, provides the basis for the use of early late more in-depth GAMLSS model.

【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R179

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