小儿精索部异位肾上腺皮质组织残留的研究  

Clinical study of ectopic adrenocortical tissue residual in spermatic cord in children

作　　者：尹鉴淳[1] 徐万华[1] 杨志林[1] 池巧梅[1] 

机构地区：[1]深圳市儿童医院泌尿外一科,518026

出　　处：《中华小儿外科杂志》2015年第7期529-531,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的通过隐睾手术中同时进行精索及睾丸探查，探讨小儿精索部异位肾上腺皮质组织残留的发生率及其与年龄、侧别的关系。方法2010年1月到2013年9月收治并实施手术的男性隐睾患儿265例；左侧122例、右侧104例、双侧39例，共304侧；年龄8个月～12岁，中位数年龄24个月。所有病例均由第一作者行经腹股沟开放隐睾下降固定手术，术中同时检查精索及睾丸附睾，发现可疑结节结构即切除送病理检查。结果术中切除并经病理检查确定精索部异位肾上腺皮质组织残留15例，占例数5．7%（151265例），占手术侧数4．9％（15／304侧），年龄1岁3个月～6岁2个月，中位数年龄21个月。以年龄分组，年龄2岁及2岁以下141例共165侧，发现异位肾上腺皮质组织残留12例，占例数8．5％，占手术侧数7．3％；年龄2岁1个月以上124例共139侧，发现异位肾上腺皮质组织残留3例，占例数2．4%，占手术侧数2．2％；两年龄组发生率比较，差异有统计学意义（Х^2检验，P〈0．05）。左侧手术143侧，共发现左侧异位肾上腺皮质组织残留8例（5．6％）；右侧手术161侧，共发现右侧异位肾上腺皮质组织残留7例（4．3％）；组间比较差异无统计学意义（Х^2检验，P〉0．05）。结论精索部异位肾上腺皮质残留发生率在5％左右，随年龄增长发生率下降。左右侧发生率无差异。Objective To assess the incidence of ectopic adrenocortical tissue （EACT） residual in groin in cryptorchidism children after orchiopexy and explore the incidence in relation to age and sides. Methods From January 2010 to September 2013, all cases underwent orchiopexy by the first author were investigated. Suspicious nodules were resected and sent for pathological examinations. A total of 304 groin explorations were performed in 265 boys. Their median age was 24 （8 144） months. And the involvements were left （n = 122）, right （n = 104） and bilateral （n = 39）. Results EACT was identified in 15 cases by pathology, accounting for 5.7% （15/265 cases） and 4. 9 %（15/304 sides） of groin explorations. In different age groups, EACT was found in 2. 4% （3/124 cases） and 2. 2% （3/ 139 sides） of groin explorations in patients aged over 25 months. In contrast, 8.5% （12/141 cases） and 7. 3% （12/165 sides） of groin explorations had EACT in patients aged under 25 months. The incidences with regard to age were different under Chi-square test （P〈0. 05）. And 5.6% （8/143 sides） had EACT at left side, 4. 3% （7/161 sides） at right side. There was insignificant difference under Chi-square test （P〈0. 05）. Conclusions The overall incidence of EACT at groin exploration in undescended testes patients is approximately 5 %and it declines with advancing age. No difference in incidence exists between left and right sides.

关 键 词：肾上腺皮质 隐睾 发病年龄 

分 类 号：R726.9[医药卫生—儿科]