宋金起,
周亚男,
屠刚亮,
许长理,
徐辉^,
承德医学院附属医院 泌尿外科, 河北 承德 067000

详细信息 作者简介: 宋金起(1994-), 男, 住院医师。E-mail:songjinqi9413@163.com





通讯作者: 徐辉, 副教授。E-mail:chengdexuhui@163.com 中图分类号: R697⁺.22


摘要:目的总结分析睾丸扭转的诊治要领。方法收集2006年2月至2019年8月共93例睾丸扭转患者的临床资料，患者最小年龄16天，最大年龄55岁，中位数14岁。93例中无诱因发病87例。隐睾扭转7例。左侧扭转71例，右侧扭转22例。对经不同术式的睾丸扭转患者，在患者年龄分布、首诊误诊情况、扭转时间、扭转角度方面进行统计和分析。结果睾丸切除患者52例（55.9%），其中首诊误诊24例（46.1%），发病年龄的中位数15.5岁（0~55岁），发病至确诊时间的中位数20.5 h（3 h~4年），扭转角度的中位数360°（180~1440°）；睾丸固定患者41例（44.1%），其中首诊误诊4例（9.8%），发病年龄的中位数13岁（0~26岁），发病至确诊时间的中位数8 h（2 h~1年），扭转角度的中位数360°（90~900°）。睾丸切除组与睾丸固定组在年龄分布上无明显差异（P>0.05）；首诊被误诊，扭转时间越长、扭转角度越大的患者，睾丸切除率越高（P < 0.05）。结论儿科、急诊科以及泌尿外科医生在接诊阴囊和腹股沟区的急症患者时要仔细查体，及时行彩超等辅助检查，降低其漏诊和误诊率；术前确诊的患者，有经验医师可尝试手法复位。尽可能缩短每个环节的时间，及时手术，减少睾丸缺血损伤，改善预后。
关键词: 睾丸扭转/
诊断/
缺血再灌注


Abstract:ObjectiveTo summarize and analyze the diagnosis and treatment essentials of testicular torsion.MethodsClinical data of 93 cases of testicular torsion in our hospital from February 2006 to August 2019 were analyzed retrospectively. The patients' age ranged from 16 days to 55 years old, with a median age of 14 years old. Of the 93 cases, 87 cases had no cause and 7 cases were torsion of cryptorchidism. There were 71 cases of left torsion and 22 cases of right torsion. The age distribution, misdiagnosis rate, testicular torsion time and torsion angle were analyzed.ResultsTesticular resection was performed in 52 patients (55.9%) with a median age of onset 15.5 years old (0~55 years old), median time from onset to diagnosis 20.5 hours (3 h~4 y) and median angle of torsion 360° (180~1440°). Among them, 24 patients (46.1%) were misdiagnosed on their initial visit. Testicular fixation was performed in 41 patients (44.1%), including 4 cases (9.8%) of misdiagnosis on their initial visit. The median age of onset was 13 years old(0~26 years old), median time from onset to diagnosis 8h (2 h~1 y), and median angle of torsion 360° (90~900°). There was no significant difference in age distribution between the orchiectomy group and the testicular fixation group (P>0.05). Testicular resection rate was higher in patients, who were misdiagnosed on the initial visit, had longer torsion time and greater torsion angle (P < 0.05).ConclusionsPediatricians, emergency doctors and urologists should take a careful physical examination and perform color Doppler ultrasound and other auxiliary examinations in a timely manner when seeing emergency patients with complaints in the scrotum and groin areas, in order to reduce the rate of missed diagnosis and misdiagnosis. For patients diagnosed preoperatively, experienced physicians may try manual reduction. Efforts should be made to shorten the time of each step as much as possible, operate in time, and reduce testicular ischemia injury, so as to save testis and improve the prognosis.
Keywords:testicular torsion/
diagnosis/
ischemia reperfusion

PDF全文下载地址:

https://journal.dmu.edu.cn/data/article/export-pdf?id=dlykdxxb_20200409