睾丸扭转35例诊治探讨  

The Clinical Analysis of Testicular Torsion(Report of 35 Cases)

作　　者：石奇刚[1] 李栓玲[1] 肖昱[1] 孙永恒[1] 杜斌[1] 

机构地区：[1]河南省濮阳市人民医院泌尿外科,河南濮阳457000

出　　处：《中国现代医生》2009年第20期159-160,共2页China Modern Doctor

摘　　要：目的探讨睾丸扭转的诊断、治疗及误诊率高的原因,提高睾丸扭转的诊治水平。方法对35例睾丸扭转患者的临床资料进行回顾性总结,寻找临床误诊的根本原因及正确的诊疗方法,并结合文献进行分析。35例患者均经彩色多普勒血流成像(color doppler flow imaging,CDFI)检查,确诊后手术治疗并行对侧睾丸固定。结果35例中误诊26例,误诊率74.29%,35例均有睾丸绞痛症状,Prehn征阳性23例。7例就诊在发病后6h内,2例就诊在发病后6～12h内,26例转入我科时距发病2～15d。手术探查结果与彩色多普勒血流成像检测相符,9例12h内确诊(25.71%),成功手术复位固定,26例发病≥2d行患侧睾丸切除(74.29%),均行对侧睾丸固定。结论睾丸扭转早期诊断、及时手术复位是挽救睾丸、减少睾丸坏死的关键。彩色多普勒血流成像检查对睾丸扭转诊断准确可靠,简便易行。临床医生提高对该病的认识是减少误诊、提高诊治水平的关键。Objective To assess the diagnosis,treatment and the reasons for the high rate of misdiagnosis concerning on testicular torsion; To improve medical effects of testicular torsion. Methods The clinical data of 35 cases and relative literature on testicular torsion were retrospectively analyzed to summarize the diagnostic experiences. The fundamental reasons of clinical misdiagnosis and correct treatments were perused. All the 35 cases,being exactly diagnosed as testicular torsion by CDFI,were salvaged by operation and orchiopexy. Results Among 35 cases,26 cases were misdiagnosed. The rate of misdiagnosis achieves 74.29%. The whole 35 cases had the essential clinical symptom of colic in testis, and 20 cases had the positive Prehn＇s sign. 7 cases received operation within 6 hours from attack time,2 cases received operation within 6 to 12 hours from attack time and the other 26 cases had lasted 2 to 15 days from attack time when they shifted in to our branch. The results of surgical exploration corresponded with inspection and measurement by CDFI;9 cases（ 〈 12h） （25.71%） were exactly diagnosed and successfully cured with manual reduction;26 cases （≥2d） （74.29%） were operated with orchiectomy and orchiopexy. Conclusion CDFI is a reliable and simple method for diagnosis of testicular torsion in time. Early diagnosis and timely reduction are the key points that increase testicular survival rate and reduce testicular necrotic rate. The Clinicians＇ prehension to testicular torsion is the key point that increases the diagnosis and reduces the misdiagnosis.

关 键 词：睾丸扭转 彩色多普勒 

分 类 号：R699.22[医药卫生—泌尿科学]