睾丸扭转49例临床分析  

Clinical analysis of 49 cases with testicular torsion

作　　者：陆群[1] 纪长威[1] 张古田[1] 连惠波[1] 张士伟[1] 李笑弓[1] 甘卫东[1] 郭宏骞[1] 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,210008

出　　处：《中华外科杂志》2015年第8期599-602,共4页Chinese Journal of Surgery

摘　　要：目的 探讨睾丸扭转的疾病特征及发病因素.方法 回顾性分析2008年4月至2014年3月南京大学医学院附属鼓楼医院收治的49例睾丸扭转患者的临床资料,患者年龄13～52岁,平均（21±6）岁.44例患者术前行阴囊彩色超声检查,其中9例显示患侧睾丸血流信号减弱,35例示睾丸无血流信号.术中根据睾丸血供恢复情况行患侧睾丸切除术或扭转复位固定术,健侧睾丸均行预防性固定术.查询2008年4月至2014年3月南京每月平均昼夜温差值.组间数据的比较采用t检验,采用Pearson相关进行相关性分析.结果 49例患者均为鞘膜内型睾丸扭转,38例（77.5％）发生于11月份至次年4月份.月平均昼夜温差与患病数呈正相关（r =0.6434,P=0.024）.44例术前彩色多普勒超声检查提示患侧睾丸血流信号减弱或消失的患者术中均证实为睾丸扭转.睾丸缺血时间6h内、6～ 12 h、12 ～ 24 h和超过24 h的睾丸保留率分别为2/2、5/15、2/9和4.2％（1/24）.所有患者随访3～75个月,平均（32±21）个月,无一例出现睾丸扭转复发.结论 睾丸扭转好发于春冬季节,昼夜温差大是重要的诱发因素,早期诊断治疗对保留睾丸十分重要.Objective To improve the diagnosis and treatment of testicular torsion.Methods The clinical features of 49 testicular torsion patients admitted to Department of Urology Nanjing Drum Tower Hospital from April 2008 to March 2014 were retrospectively analyzed,the average age was （21 ± 6） years （range 13-52 years）.Forty-four cases underwent the color Doppler flow imaging of scrotum,demonstrated reduction of the testicular blood supply in 9 cases and loss of the testicular blood supply in 35 cases.Orchiectomy or orchiopexy was performed according to the testicular blood supply,the contralateral testis fixation was performed in all patients.A two-tailed Student＇s t-test was used to compare the data between two groups,Pearson correlation analysis was used to analyze the correlation of diurnal temperature and number of cases.Results All the patients with testicular torsion were Tunica-reversed,38 （77.5%） cases occurred from November to April.The monthly incidence of testicular torsion was positively correlated with diurnal temperature （r =0.6434,P =0.024）.Forty-four cases underwent the color Doppler flow imaging,demonstrated the reduction or loss of the testicular blood supply,and these patients were confirmed to be testicular torsion by surgical exploration.The salvage rates of testis in patients with testicular torsion were 2/2,5/15,2/9 and 4.2% （1/24） in those seeking medical attention within 6,12,24 hours and over 24 hours after the onset of pain.All the patients were followed up for 3 to 75 months,and no one experienced recurrent torsion.Conclusions The incidence of testicular torsion is higher during the spring and winter,diurnal temperature change is associated with testicular torsion.The diagnostic rate of color Doppler flow imaging is high,which can be chosen as the primary method.Prompt recognition and treatment are necessary for testicular salvage.

关 键 词：精索扭转 季节 诊断 治疗 

分 类 号：R699.8[医药卫生—泌尿科学]