以腹痛为初发症状的睾丸扭转临床分析  

Clinical Analysis of Testicular Torsion with Abdominal Pain as the Initial Symptom

作　　者：李金峰 林阳 李福林 赵兴 张永波 邓常开 彭强 李茂仙 LI Jinfeng;LIN Yang;LI Fulin;ZHAO Xing;ZHANG Yongbo;DENG Changkai;PENG Qiang;LI Maoxian(The Affiliated Women's and Children's Hospital,School of Medicine,University of Electronic Science and Technology of China/Chengdu Women's and Children's Center Hospital,Chengdu 611731,Sichuan,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院/成都市妇女儿童中心医院,四川成都611731

出　　处：《现代诊断与治疗》2024年第4期475-478,共4页Modern Diagnosis and Treatment

摘　　要：目的 探讨以腹痛为初发症状睾丸扭转患者的临床特点。方法 回顾性分析2011年6月至2021年6月我院收治的126例经手术证实为睾丸扭转患者,将其中23例初发症状为腹痛的患者纳入研究。结果 23例患者年龄9~15岁,中位年龄12岁;初发症状均为急性腹痛,伴呕吐11例、伴腹股沟区疼痛10例、伴转移性右下腹痛1例、伴阴茎根部痛1例。23例患者中仅6例首诊行外生殖器检查,首诊误诊率为73.9%。手术探查发现16例患者因睾丸坏死行睾丸切除术,仅7例患者睾丸得以保留。术后随访6~42个月,中位随访时间18个月,保留睾丸者中有2例发生睾丸萎缩,切除睾丸者未见并发症。结论 以腹痛为初发症状睾丸扭转患者往往缺乏典型的睾丸疼痛易误诊。建议对腹痛患者常规行外生殖器检查,这有助于降低睾丸扭转的误诊和漏诊率。Objectives Toexplore the clinical characteristics of the testicular torsion patients initially presenting with acute abdominal pain.Methods The clinical data of 126 patients with testicular torsion confirmed by surgery in our hospital from Jun 2011 to Jun 2021 were retrospectively studied.Among them,23 patients with initial symptoms of abdominal pain were included in the study.Results The age of 23 patients ranged from 9 to 15 years old,with a median age of 12 years old.The initial symptoms were acute abdominal pain,with scrotal pain in all patients,with vomiting in 11 cases,groin pain in 10 cases,metastatic right lower abdominal pain in 1 case,and penile root pain in 1 case.Of the 23 patients,only 6 were examined for scrotum and testicles during the first physical examination,and the misdiagnosis rate was 73.6%.Surgery exploration found that 16 patients underwent orchiectomy due to testicular necrosis,and only 7 patients had their testes preserved.The patients were followed up for 6 to 42 months,with a median follow-up time of 18 months.Testicular atrophy occurred in 2 cases of testicular preservation,and no complications occurred in other cases who underwent testicular resection.Conclusions Patients with abdominal pain as the initial symptom of testicular torsion often lack typical testicular pain and are easily misdiagnosed.It is recommended to routinely perform external genital examination in patients with abdominal pain,which helps to reduce the misdiagnosis and missed diagnosis rate of testicular torsion.

关 键 词：睾丸扭转 腹痛 误诊 

分 类 号：R726.9[医药卫生—儿科]