剪切波弹性成像评估睾丸扭转筋膜室减压治疗对生精功能的保护效应  

Shear wave elastography to evaluate the protective effect of testicular torsion fascial compartment decompression treatment on spermatogenesis

作　　者：李志勇 薛恩生[1] 林文金[1] 苏唤忠 Li Zhiyong;Xue Ensheng;Lin Wenjin;Su Huanzhong(Department of Ultrasound,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院超声科,福州350001

出　　处：《中华超声影像学杂志》2021年第7期631-635,共5页Chinese Journal of Ultrasonography

基　　金：福建省教委科研基金(JA15220)。

摘　　要：目的探讨剪切波弹性成像(SWE)评估睾丸筋膜室减压术对睾丸扭转复位后生精功能保护效应的可行性。方法将32只兔子随机分为对照组(S组)、睾丸扭转单纯复位组(I组)及睾丸扭转复位+筋膜室减压术组(T组:T1组、T2组)共4组,每组8只。I、T组建立术侧睾丸完全扭转模型后,I组予单纯复灌注,T组复灌注后再行筋膜室减压术。各组兔子建模成功后继续饲养30 d。各组兔子术前、完全扭转建模成功后、复灌注后及30 d后均行睾丸筋膜室内压测量及SWE检查,实验结束后取术侧睾丸行病理学检查。结果睾丸扭转后,各实验组术侧睾丸筋膜室压力及睾丸组织杨氏模量平均值(Emean)升高(均P<0.05),且随着扭转时间延长进一步升高(均P<0.05)。复灌注后,I组睾丸筋膜室压力及睾丸组织Emean进一步升高(均P<0.05),而T组睾丸筋膜室压力及睾丸组织Emean降低(均P<0.05)。30 d后,I组睾丸筋膜室压力及睾丸组织Emean均大于T组(P<0.05),而睾丸组织Johnsen′s评分小于T组(P<0.05),睾丸组织凋亡指数及丙二醛含量大于T组(均P<0.05)。结论睾丸筋膜室减压术对睾丸扭转复位后生精功能具有一定保护效应。SWE可以间接评估睾丸扭转及复位后睾丸筋膜室综合征的严重程度及筋膜室减压术对生精功能的保护效果。Objective To investigate the feasibility of shear wave elastography(SWE)to evaluate the protective effect of testicular compartment decompression on spermatogenesis after testicular torsion reduction.Methods Thirty-two rabbits were randomly divided into 4 groups:control group(S group),testicular torsion simple reduction group(I group),and testicular torsion reduction+compartment decompression group(T group:T1 group,T2 group),8 rabbits per group.After the complete testicular torsion model was established in the I and T groups,the I group was simply reperfused,and the T group was reperfused before decompression of the compartment.Rabbits in each group were kept for 30 days after successful modeling.Each group of rabbits underwent testicular fascia intracompartment pressure measurement and SWE examination before operation,after successful complete torsion modeling,after reperfusion and 30 days later.After the experiment,the surgical side testicles were taken for pathological examination.Results After testicular torsion,the pressure of testicular fascia and the average Young′s modulus(Emean)of testicular tissue in each experimental group increased(all P<0.05),and further increased with the extension of torsion time(all P<0.05).After reperfusion,the testicular fascial compartment pressure and testicular tissue Emean value in group I further increased(all P<0.05),while the testicular fascial compartment pressure and testicular tissue Emean value in group T decreased(all P<0.05).Thirty days later,testicular fascial compartment pressure and testicular tissue Emean value in group I were higher than those in group T(all P<0.05),while Johnsen′s score of testicular tissue was lower than that in group T(P<0.05),and testicular tissue apoptosis index and malondialdehyde content were higher than those in group T Group T(all P<0.05).Conclusions Decompression of the testicular compartment has a protective effect on spermatogenesis after testicular torsion reduction.SWE can indirectly evaluate the severity of testicular compart

关 键 词：剪切波弹性成像 睾丸扭转 睾丸筋膜室综合征 睾丸筋膜室减压术 

分 类 号：R697.22[医药卫生—泌尿科学]