睾丸结核11例临床分析  

Testicular tuberculosis: A clinical analysis of 11 cases

作　　者：董传江[1,2] 董自强[2] 沈洲[1] 贾仁峰[1] 张龙[1] 李兵[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022 [2]三峡大学第一临床医学院,宜昌市中心人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2013年第3期207-208,211,共3页Journal of Clinical Urology

摘　　要：目的:分析睾丸结核误诊误治的相关因素,探讨临床睾丸结核诊断及治疗方法。方法:回顾性分析2008～2011年收治11例睾丸结核患者的临床资料。结果:睾丸结核患者病史3～18个月。11例睾丸结核中合并附睾结核10例,合并肺结核6例。5例曾被误诊为附睾睾丸炎。误诊主要原因是早期临床表现不典型,缺乏影像学检查。11例中,7例通过术后病理检查结果确诊,4例经睾丸穿刺活检确诊。误诊时间平均4个月。3例经6个月抗结核治疗后痊愈,8例经抗结核及手术治疗后痊愈,随访6个月未见复发。结论:睾丸结核临床少见,漏误诊率较高。B超、CT、MRI和睾丸穿刺细胞学检查有助于睾丸结核诊断。对于局部干酪样坏死严重,病变较大且有脓肿形成或抗结核治疗效果不明显的患者可以考虑手术治疗。Objective： To analyze the factors leading to misdiagnosis of testicular tuberculosis and summarize the diagnosis and treatment of testicular tuberculosis. Methods：The clinical data of 11 patients with testicular tuberculosis from 2008 to 2011 were identified and retrospectively reviewed. Results：These 11 patients were 17 to 74 years old （mean age 37 years）. The course of this disease was 3 to 18 months. All patients presents with a painless or slightly painful scrotal mass. In all 11 patients, 10 cases combined with epididymal tuberculosis, 6 cases with pulmonary tuberculosis. Five cases had been misdiagnosed as epididymal orchitis. Clinical misdiagnosis is mainly due to the fact that testieular tuberculosis is rare, the early clinical manifestations of testicular tuberculosis are not typical and imaging examinations are absent. Of 11 cases, 7 cases were diagnosed by pathological examination after operation, 4 cases of testicular were diagnosed through biopsy. In these patients, the mean misdiagnosed time was 4 months, 3 cases were cured after six months＇ anti-TB treatment, and 8 cases were cured after anti-TB treatment and surgical treatment. There was no recurrence at a 6 month follow-up. Conclusions： Testicular tuberculosis is rare, the misdiagnosis rate is high. Ultrasound, CT, MRI and testicular fine needle aspiration biopsy are effective in diagnosis and differential diagnosis of testicular tuberculosis. Surgical treatment should be considered if serious caseous necrosis, large lesions and abscess formation and/or failure of anti-TB drug treatment occur.

关 键 词：睾丸结核 诊断 治疗 

分 类 号：R697[医药卫生—泌尿科学]