108例睾丸扭转患儿的临床诊治特点及多因素回归分析  

Clinical diagnosis and treatment of 108 cases of testicular torsion and multivariate regression analysis

作　　者：胡建军 赵夭望[1] 陈毅夫[1] 何天衢 彭柳成 Hu Jianjun;Zhao Yaowang;Chen Yifu;He Tianqu;Peng Liucheng(Department of Urology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院泌尿外科,长沙410007

出　　处：《国际泌尿系统杂志》2024年第3期521-525,共5页International Journal of Urology and Nephrology

基　　金：国家临床重点专科建设项目(湘卫医发[2022]2号);湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017)。

摘　　要：目的:探讨睾丸扭转的临床诊治特点,评估睾丸扭转中睾丸切除的风险因素。方法:回顾性分析2017年1月至2021年12月本院收治的108例睾丸扭转患儿的临床资料,根据睾丸治疗结果将患儿分为睾丸保留组(26例)和睾丸切除组(82例)。纳入年龄、病程、地区、扭转度数、首次就诊医院级别等多因素构建Poisson回归方程分析睾丸扭转中睾丸切除的影响因素。结果:两组患儿的年龄、病程、扭转度数、地区分布、首次就诊医院级别比较,差异均有统计学意义(均P<0.05),而季节、扭转位置、扭转方向、扭转类型比较,差异均无统计学意义(均P>0.05)。多因素回归分析结果显示,年龄、病程、地区、扭转度数、首次就诊医院级别均是睾丸切除的影响因素(均P<0.05)。采用乘积极限法绘制病程、扭转度数、年龄、季节与睾丸扭转的生存分析函数曲线,结果显示:随着病程及扭转度数增加,睾丸保留率明显下降,中位生存扭转度数为540°;中位生存病程为48 h。结论:急诊手术探查是睾丸扭转的最佳治疗方案,年龄、病程、地区、扭转度数、首次就诊医院级别为睾丸扭转中睾丸切除的危险因素,年龄减低、病程增长、扭转度数增大、首次就诊医院级别减低、远离城市可增加睾丸扭转疾病的睾丸切除率。Objective To investigate the clinical features of testicular torsion,to evaluate risk factors for testicular torsion and orchiectomy.Methods The clinical data of 108 children with testicular torsion admitted to our hospital from January 2017 to December 2021 were retrospectively analyzed.According to the results of testicular treatment,the patients were divided into testicular preservation group(26 cases)and testicular resection group(82 cases).Poisson regression equation analysis of influencing factors of orchiectomy was constructed with age,course of disease,region,degree of torsion,first visit hospital level and other factors.Results There were statistically significant differences in age,course of disease,degree of torsion,regional distribution,and hospital grade of first visit between the two groups(all P<0.05),but there were no statistically significant differences in season,position,direction and type of torsion between the two groups(all P>0.05).Multivariate regression analysis showed that age,course of disease,region,degree of torsion,and grade of first visit hospital were the influencing factors of orchiectomy(all P<0.05).Product limit method was used to plot the survival analysis function curves of disease course,torsion degree,age,season and testicular torsion.The results showed that with the increase of disease course and torsion degree,testicular retention rate decreased significantly.The median survival torsion degree was 540°.The median survival course was 48 h.Conclusions Age,course of disease,region,degree of torsion and hospital grade of first visit are risk factors for testicular torsion and testicular resection.Lower age,longer course of disease,higher degree of torsion,lower degree of hospital grade of first visit and distance from city increase testicular resection rate.

关 键 词：睾丸切除术 睾丸扭转 儿童 

分 类 号：R726.9[医药卫生—儿科]