睾丸扭转患儿平均血小板体积与睾丸活性的相关性  

Correlation between the mean platelet volume and testicular viability in children with testicular torsion

作　　者：李慕婕 何梦 谢向辉[1] 张潍平[1] Li Mujie;He Meng;Xie Xianghui;Zhang Weiping(Department of Urology,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院泌尿外科,北京100045

出　　处：《中华实用儿科临床杂志》2022年第3期191-195,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的研究睾丸扭转患儿血液学参数与睾丸活性的相关性,探讨术前预测扭转睾丸活性或睾丸萎缩的指标。方法回顾性分析2006年1月至2020年1月于首都医科大学附属北京儿童医院泌尿外科行急诊手术治疗的173例睾丸扭转患儿的临床资料,根据手术方式分为睾丸复位固定术组83例,睾丸切除术组90例,采用独立样本t检验、χ^(2)检验、Mann-Whitney U检验法对比2组患儿的发病时长、精索扭转度数和血液学参数等指标,对睾丸切除的危险因素行多因素Logistic回归分析。随访睾丸复位固定术组的83例患儿,术后6个月复查双侧阴囊彩超患儿共30例,分为睾丸萎缩组13例(43.3%),睾丸非萎缩组17例,采用独立样本t检验、Mann-Whitney U检验法比较2组的各项参数,对发病时长为>6-<51 h患儿中差异有统计学意义的指标行受试者工作特征曲线(ROC)分析。结果发病时长(9.3 h比51.0 h)(Z=-8.293,P<0.001)、精索扭转度数(360.0°比540.0°)(Z=-5.267,P<0.001)、平均血小板体积(MPV)(9.8 fL比10.1 fL)(Z=-2.018,P=0.044)和年龄(147.5个月比143.0个月)(Z=-2.165,P=0.030)在睾丸复位固定术组和睾丸切除术组间的差异均有统计学意义。多因素分析提示,发病时长(OR=1.033,P<0.001)、精索扭转度数(OR=1.004,P<0.001)和MPV(OR=1.662,P=0.044)与睾丸丢失均呈正相关。分析发病时长为>6-<51 h的患儿的发病时长、精索扭转度数和MPV的ROC曲线,三者的曲线下面积(AUC)分别为0.753、0.755、0.629。在睾丸萎缩组和睾丸非萎缩组的对比中,组间仅MPV的差异有统计学意义[(10.2±0.5)fL比(9.8±0.5)fL](t=2.426,P=0.022)。ROC曲线分析提示,MPV预测睾丸萎缩的截断值为9.9 fL,敏感性为83.3%,特异性为70.6%,AUC为0.752。结论发病时长、精索扭转度数和MPV可作为术中睾丸活性的预测指标,有助于临床医师术前早期预测和判断睾丸扭转所致的睾丸坏死。此外,43.3%保留了扭转睾丸的患儿在睾丸复位固定术�Objective To investigate the correlation between hematological parameters and testicular viability,and to identify potential indicators of intraoperative testicular viability or postoperative testicular atrophy.Methods Clinical data of 173 children with testicular torsion treated by emergency operation in the Department of Urology,Beijing Children′s Hospital,Capital Medical University from January 2006 to January 2020 were retrospectively analyzed.According to the surgical methods,90 and 83 cases were included in the orchiectomy group and orchiopexy group,respectively.The duration of onset,spermatic cord torsion degree and hematological parameters of the 2 groups were compared by the independent-samples t test,χ^(2) test and Mann-Whitney U test.Risk factors for testicular resection were analyzed by multivariate Logistic regression.In addition,30 children in the orchiopexy group were followed up for bilateral scrotal ultrasound at 6 months postoperatively.They were sub-grouped into testicular atrophy group(13 cases,43.3%)and non-atrophy group(17 cases).Differences between 2 subgroups were compared by the independent-samples t test and Mann-Whitney U test.Receiver operating characteristic(ROC)curves were plotted to analyze the prognostic potentials of indexes with significant differences in children with the duration of onset of>6-<51 h.Results Duration of onset(9.3 h vs.51.0 h)(Z=-8.293,P<0.001),spermatic cord torsion degree(360.0°vs.540.0°)(Z=-5.267,P<0.001),mean platelet volume(MPV)(9.8 fL vs.10.1 fL)(Z=-2.018,P=0.044)and age(147.5 months vs.143.0 months)(Z=-2.165,P=0.030)were significantly different between the orchiopexy group and the orchiectomy group.The multivariate Logistic regression analysis suggested that the duration of onset(OR=1.033,P<0.001),spermatic cord torsion degree(OR=1.004,P<0.001)and MPV(OR=1.662,P=0.044)were positively correlated with testicular resection.For patients with the duration of onset of>6-<51 h,the area under the curve(AUC)of duration of onset,spermatic cord torsion degree an

关 键 词：平均血小板体积 睾丸切除术 睾丸固定术 睾丸扭转 睾丸萎缩 

分 类 号：R726.9[医药卫生—儿科]