婴幼儿阴囊急症的临床分析  

Clinical analysis of acute scrotal in infants and children

作　　者：夏红亮[1] 周云[1] 严向明[1] 张婷[1] 付明翠[1] 曹戌[1] XIA Hong-liang;ZHOU Yun;YAN Xiang-ming;ZHANG Ting;FU Ming-cui;CAO Xu(Urology Department, Children's Hospital of Soochow University, Suzhou 215003, China)

机构地区：[1]苏州大学附属儿童医院泌尿外科

出　　处：《临床医学研究与实践》2019年第17期86-88,共3页Clinical Research and Practice

摘　　要：目的分析婴幼儿阴囊急症的病因和临床特征并探讨其临床诊断和处理方法。方法回顾性分析我院2010年1月至2018年12月收治的53例婴幼儿阴囊急症患儿的临床资料,分析婴幼儿阴囊急症病因和临床表现并探讨其临床诊断和处理方法。结果 53例阴囊急症患儿年龄1 d至10个月27 d,平均年龄4个月。其中急性附睾炎41例(77.4%),睾丸扭转10例(18.9%),阴囊脓肿2例(3.8%)。患儿均出现阴囊红肿症状,就诊时阴囊红肿出现时间1 h至3 d。急性附睾炎经彩色多普勒超声确诊33例(80.5%),超声提示附睾体积增大,附睾血流增多;8例(19.5%)经手术证实,超声提示睾丸/附睾血流不均。睾丸扭转和阴囊脓肿均为超声确诊。急性附睾炎患儿实验室检查血常规异常31例(75.6%),C反应蛋白升高35例(85.4%),应用抗生素前尿常规异常17例(41.5%),其中尿培养阳性5例,均为大肠埃希菌。术中取患儿脓液进行培养,阳性3例,1例链球菌,2例大肠埃希菌。睾丸扭转患儿入院后行手术探查,切除坏死睾丸。阴囊脓肿患儿入院后行脓肿切开引流术。结论婴幼儿阴囊急症中急性附睾炎和睾丸扭转较为常见,两者鉴别诊断主要靠彩色多普勒超声,对不能及时确诊的患儿需行手术探查。Objective To analyze the etiology and clinical characteristics of acute scrotal in infants and children, and to explore its clinical diagnosis and treatment methods. Methods The clinical data of 53 cases of acute scrotal in infants and children admitted in our hospital from January 2010 to December 2018 were retrospectively analyzed, the etiology and clinical manifestations of acute scrotal were analyzed, and the clinical diagnosis and treatment methods were explored.Results Fifty-three infants or children with acute scrotal were aged from 1 day to 10 months and 27 days, with an average age of 4 months. Among them, 41 cases(77.4%) were acute epididymitis, 10 cases(18.9%) were testicular torsion and 2 cases(3.8%) were scrotal abscess. The symptoms of scrotal redness and swelling occurred in all the children, the occurrence time of scrotal redness and swelling was from 1 hour to 3 days at the time of consultation. Acute epididymitis diagnosed by color Doppler ultrasonography were 33 cases(80.5%), and ultrasound showed that the volume of epididymis increased and the blood flow of epididymis increased;8 cases(19.5%) were confirmed by operation, and ultrasound showed that the blood flow of testis/epididymis was uneven. Testicular torsion and scrotal abscess were diagnosed by ultrasonography. Thirty-one cases(75.6%) of children with acute epididymitis had abnormal blood routine examination, 35 cases(85.4%) had elevated C-reactive protein, 17 cases(41.5%) had abnormal urine routine examination before using antibiotics, and 5 cases of them had positive urine culture and the culture bacteria were Escherichia coli. The pus during the operation was cultured, 3 cases were positive, 1 case was Streptococcus and 2 cases were Escherichia coli. Children with testicular torsion underwent surgical exploration after admission and necrotic testicles were removed. Children with scrotal abscess were treated with abscess incision and drainage after admission. Conclusion Acute epididymitis and testicular torsion are more common in acute

关 键 词：婴幼儿阴囊急症 睾丸扭转 急性附睾炎 彩色多普勒超声 

分 类 号：R726.92[医药卫生—儿科]