新生儿睾丸扭转17例临床分析  

Neonatal testicular torsion: a study of 17 cases

作　　者：高晓峰 周锐 束方鹏 朱士博 李典 刘国昌 贾炜 伏雯 Xiaofeng Gao;Rui Zhou;Fangpeng Shu;Shibo Zhu;Dian Li;Guochang Liu;Wei Jia;Wen Fu(Department of Pediatric Urology,Guangzhou Women and Children's Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心小儿泌尿外科,广州510623

出　　处：《中华新生儿科杂志（中英文）》2023年第11期675-678,共4页Chinese Journal of Neonatology

摘　　要：目的探讨新生儿睾丸扭转(neonatal testicular torsion,NTT)的临床特点及治疗情况,总结诊治经验。方法选择2015年1月至2021年1月广州市妇女儿童医疗中心小儿泌尿外科收治的NTT病例为研究对象,对患儿基本情况、睾丸扭转时间、临床表现、超声检查结果、手术方法、病理结果、随访及预后等进行回顾性分析。结果共纳入17例NTT患儿,入院日龄1~17 d,中位数为5.2 d,体重2800~4000 g。左侧睾丸扭转11例,右侧6例。睾丸扭转起病至就诊中位时间3.8 d(10 h~15 d)。首发临床症状为阴囊肿大、颜色改变或无痛性肿块,急诊超声提示睾丸内血流信号明显减少或消失,阴囊内探及回声不均质团块。17例均手术探查,证实为睾丸扭转。鞘膜外型15例,鞘膜内型2例;逆时针扭转11例,顺时针扭转6例;扭转角度平均450.8°,范围270°~720°。15例(15/17)行睾丸切除。术后随访1年,患儿术后切口均无出血或感染,无睾丸扭转复发,手术对侧睾丸无异常。2例保留患侧睾丸者术后6个月复查超声均提示患侧睾丸已萎缩。结论NTT临床少见且缺乏特异性表现,失睾率极高。当新生儿出现阴囊肿大、颜色改变等异常不排除睾丸扭转时,需及早手术探查。Objective To study the clinical manifestations and treatment of neonatal testicular torsion(NTT)and to summarize the experience of diagnosis and treatment.Methods The clinical data of the patients with NTT admitted to the Department of Pediatric Urology in Guangzhou Women and Children's Medical Center from January 2015 to January 2021 were analyzed retrospectively.The data included demographic information,testicular torsion duration,clinical presentation,ultrasonography findings,surgical procedures,pathological results,follow-ups,and prognosis.Results A total of 17 cases were enrolled in this study,and the median age was 5.2 d,ranging from 1 d to 17 d;the weight ranging from 2800 g to 4000 g.11 cases of left testicular torsion and 6 cases of right testicular torsion.The median time from onset to medical attention was 3.8 d,ranging from 10 h to 15 d.The first manifestations being reported were scrotal swelling,color change,or painless mass.Emergency ultrasound revealed that the blood flow signal in the testis was significantly reduced or disappeared,and heterogeneous mass echoes were detected in the scrotum.Surgical exploration was performed in all 17 cases and confirmed to be testicular torsion.There were 15 cases of extravaginal torsion and 2 cases of intravaginal torsion.There were 6 cases of clockwise torsion and 11 cases of anticlockwise torsion.The average degree of twisted testis was 450.8°,ranging from 270°to 720°.The rate of orchiectomy was 88.2%(15/17).All patients were followed up for a minimum of 1 year postoperatively.None of the patients experienced postoperative bleeding or infection at the scrotal incision site.There were no instances of recurrent testicular torsion,and the contralateral testicles showed no abnormalities.In 2 cases where the affected testicle was preserved,ultrasound reevaluation at 6 months postoperatively revealed atrophy of the affected testicle.Conclusions NTT is rare in clinics and lacks specificity,with a high rate of testis loss.When the newborns exhibit scrotal swelling,

关 键 词：新生儿 睾丸扭转 睾丸切除 手术探查 

分 类 号：R73[医药卫生—肿瘤]