不同年龄单侧隐睾手术前后睾丸生长情况的对比研究  

Comparative study on testicular growth before and after unilateral cryptorchid surgery at different ages

作　　者：马达 郭燕萍 吴锐发 王意 蒋双兰 饶春宝 吴国兴 MA Da;GUO Yanping;WU Ruifa;WANG Yi;JIANG Shuanglan;RAO Chunbao;WU Guoxing(Department of Pediatric Surgery,Dongguan Children’s Hospital in Guangdong Province,Dongguan 523325,China)

机构地区：[1]广东省东莞市儿童医院小儿外科,广东东莞523325

出　　处：《中国现代医生》2020年第14期9-12,共4页China Modern Doctor

基　　金：广东省东莞市社会科技发展(重点)项目(201750715028453)。

摘　　要：目的 通过比较9月龄和3岁年龄睾丸下降固定术后的先天性单侧隐睾患儿的睾丸生长情况,评价隐睾睾丸下降固定术时机.方法 收集我院2014年1月~2016年1月接受睾丸下降固定手术治疗的单侧隐睾患儿,随机分为9月龄组(72例)和3岁龄组(83例).通过超声检查对比两组患儿在6、12、24、36和48个月时的睾丸体积,使用SAS中的PROC MIXED对数据进行分析,从而评价手术时机.结果 在9月龄组患儿中,分别在2、3和4岁时进行随访测量的睾丸体积明显增加(P<0.001).相反,在3岁龄组中没有观察到明显的增长.通过从6个月到4岁睾丸增长的比率逐渐增加说明9个月大时睾丸固定术后患儿睾丸生长情况得到改善(0.68~1.81,P<0.001).对于3岁龄组,在同一时期该比率显著下降(0.68~0.56,P<0.001).结论 与3岁手术相比,9个月手术治疗组中其4岁时睾丸大小与正常同龄儿童相比基本一致,表明早期手术对睾丸生长是有益的.因此早期行睾丸下降固定术可能给隐睾患儿改善未来的生育能力提供机会.Objective To evaluate the timing of cryptorchid testicular descent fixation by comparing the testicular growth of children with congenital unilateral cryptorchidism at 9 months and 3 years of age after testicular descent fixation surgery.Methods Children patients with unilateral cryptorchidism who were given testicular descend fixation surgery from January 2014 to January 2016 in our hospital were collected and randomly divided into 9-month group(72 cases)and 3-year-old group(83 cases).The testicular volume was compared between the two groups of children at 6,12,24,36 and 48 months by ultrasound,and PROC MIXED in SAS was used to analyze the data to evaluate the timing of surgery.Results In the group of 9-month children patients,the testicular volume which was measured at follow-up visits was significantly increased at 2,3,and 4 years of age(P<0.001).In contrast,no significant increase was observed in the 3-year-old group.The gradual increase in the rate of testicular growth from 6 months to 4 years of age illustrated that the testicular growth in children patients was improved after testicular fixation received at 9 months of age(0.68 to 1.81,P<0.001).For the 3-year-old treatment group,this ratio was decreased significantly over the same period(0.68 to 0.56,P<0.001).Conclusion Compared with the surgery in the 3-year-old group,the testicle size at the age of 4 in the 9-month surgical treatment group is basically the same as that of healthy children of the same age,indicating that early surgery is beneficial for testicular growth.Therefore,early testicular descent fixation surgery may provide opportunities for children patients with cryptorchidism to improve future fertility.

关 键 词：睾丸 隐睾症 睾丸下降固定术 手术时机 

分 类 号：R726.9[医药卫生—儿科]