儿童睾丸扭转的诊断与治疗——附221例病例分析  

Diagnosis and treatment of testicular torsion in children——analysis of 221 cases

作　　者：汪丹 占雄[1] 吴谋东 曾荣阳 安妮妮[1] 彭金普 WANG Dan;ZHAN Xiong;WU Moudong;ZENG Rongyang;AN Nini;PENG Jinpu(Department of Pediatric Surgery,Guizhou Provincial People’s Hospital,Guizhou 550002,China)

机构地区：[1]贵州省人民医院小儿外科,550002 [2]重庆医科大学附属儿童医院小儿外科

出　　处：《临床外科杂志》2024年第10期1088-1090,共3页Journal of Clinical Surgery

基　　金：贵州省人民医院博士基金项目(GZSYBS202204号)。

摘　　要：目的分析儿童睾丸扭转的临床特点、治疗方法及预后。方法重庆医科大学附属儿童医院及我院小儿外科2003年5月~2023年5月收治睾丸扭转患儿221例,分析其临床特点、治疗经过及转归。结果儿童睾丸扭转发病年龄高峰为婴儿期及青春前期(71%)。左侧发病率(77%)高于右侧(23%)。睾丸扭转首发症状主要以阴囊疼痛红肿为主(62%),部分病例以下腹痛和腹股沟区疼痛为首发表现(11%)。基层医院就诊病人误诊、误治率高。辅助检查首选阴囊彩超,主要表现为睾丸未见血供或血供明显减少,轴向异常。睾丸扭转就诊黄金时间为8小时以内。病理损害8小时内以间质充血水肿、曲细精管变性为主,>8小时均表现为出血坏死或出血性梗死。结论儿童睾丸扭转以小婴儿和青春前期儿童多发,左侧多于右侧;主要症状为阴囊疼痛红肿,亦有下腹或腹股沟疼痛;睾丸病理损害与就诊时间和扭转程度密切相关。Objective To improve the level of diagnosis and treatment through analyzing the clinical characteristics,treatment and prognosis with testicular torsion in children.Methods We conducted a retrospective analysis of 221 boys with testicular torsion,who received trearment from May 2003 to May 2023 at the Children’s Hospital of Chongqing Medical University and Guizhou Provincial People’s Hospital.Data analysed included:clinical characteristics,treatment progress and outcome.Results The peak onset age of testicular torsion in children was infancy and prepuberty(71%).The incidence of left side(77%)was higher than that of right side(23%).The first symptoms were mainly scrotal pain and swelling(62%),but some cases mainly manifested lower abdominal pain and inguinal pain(11%).The rate of misdiagnosis and mistreatment of patients in basic hospitals was high.Scrotal color Doppler ultrasonography is the first choice for assistant examination,and mainly showed none or dramatically decrease of blood supply in testis,and abnormal axial direction.The golden time for testicular torsion diagnosis was within 8 hours.The chief pathological manifestation were interstitial hyperemia,edema and seminiferous tubules degeneration within 8 hours,and hemorrhagic necrosis or infarction over 8 hours.Conclusions Children Testicular torsion occurs more frequently in infancy and prepuberty,torsion position in the left side is more than that in right side.The main symptoms are scrotal pain and swelling,as well as lower abdominal or inguinal pain.Testicular pathological lesion is closely associated with the diagnosis time and degree of torsion.

关 键 词：睾丸扭转 阴囊急症 儿童 

分 类 号：R726.9[医药卫生—儿科]