阴囊镜在39例睾丸附睾疾病诊治中的应用  

Scrotoscopy in the diagnosis and treatment of testicular and epididymal diseases:Analysis of 39 cases

作　　者：徐乐 黎灿强 邱敏捷 杨毅 XU Le;LI Can-qiang;QIU Min-jie;YANG Yi(Department of Urology,He Xian Memorial Hospital Affiliated to Southern Medical University,Guangzhou,Guangdong 511400,China)

机构地区：[1]南方医科大学附属何贤纪念医院泌尿外科,广东广州511400

出　　处：《中华男科学杂志》2020年第2期134-138,共5页National Journal of Andrology

基　　金：广州市医药卫生科技项目(20171A010337)。

摘　　要：目的:评估阴囊镜在睾丸附睾疾病诊断和治疗中的有效性和安全性,探讨其临床应用价值. 方法:对2015年2月至2018年2月接受阴囊镜手术的39例患者临床资料进行回顾性分析,观察阴囊镜术后疗效,术后阴囊疼痛评分及并发症、病损复发情况. 结果:39例患者均成功实施阴囊镜手术,未出现阴囊血肿、睾丸破裂等严重并发症.13例附睾肿物均予镜下钬激光完整切除;12例慢性睾丸疼痛患者镜下确诊为睾丸(附睾)附件不全扭转,10例予镜下钬激光切除;11例怀疑睾丸扭转的患者中8例术中确诊睾丸扭转,另外3例确诊急性附睾炎;3例阴囊外伤后陈旧性血肿患者予镜下血肿清除术电切攀电凝止血.所有患者术后均未出现阴囊切口感染等并发症,疼痛视觉模拟评分2~5(3.4±1.2)分,住院时间3~6(3.2±0.8)d,术后1个月均接受阴囊彩超检查,提示患侧睾丸、附睾及精索未见异常. 结论:应用阴囊镜技术诊治睾丸附睾疾病安全有效,有一定的临床意义,值得推广.Objective:To investigate the efficiency,safety and clinical application value of scrotoscopy in the diagnosis and treatment of testicular and epididymal diseases.Methods:A total of 39 patients with testicular or epididymal diseases underwent scrotoscopic surgery in our hospital from February 2015 to February 2018.We retrospectively analyzed the clinical data,results of surgery,and postoperative scrotal pain scores,complications and recurrence.Results:Scrotoscopic surgery was successfully performed in all the 39 cases,without such severe complications as testis mpture and scrotal hematoma.Thirteen cases of epididymal tumor were treated by total excision of the tumors by laser ablation;10 of the 12 patients complaining of chronic testicular pain were diagnosed with incomplete torsion of testicular or epididymal appendages and treated by holmium laser ablation;of the 11 cases of suspected testicular torsion,8 were confinned as testicular torsion and the other 3 as acute epididymitis;and 3 cases of scrotal trauma-induced old hematoma underwent surgical removal under the scrotoscope.No infection of scrotal incision occurred postoperatively.The visual analog pain scores of the patients averaged 3.4±1.2(2-5)and their hospital stay 3.2±0.8(3-6)days.Scrotal ultrasonography at 1 month after surgery revealed no abnormality in the testis,epididymis or spermatic cord.Conclusion:Scrotoscopy is safe and effective for the diagnosis and treatment of testicular and epididymal diseases and deserves a wide clinical application.

关 键 词：阴囊镜 睾丸疾病 附睾疾病 诊断 治疗 

分 类 号：K697.2[历史地理—历史学]