睾丸扭转诊治模式的相关分析  

Diagnostic and treatment strategies for testicular torsion

作　　者：孟庆松[1] 张婉泽 张明[1] 贾江华[1] 汪鑫[1] 马万里 王耀华 王亚轩[1] 齐进春[1] MENG Qing-song;ZHANG Wan-ze;ZHANG Ming;JIA Jiang-hua;WANG Xin;MA Wan-li;WANG Yao-hua;WANG Ya-xuan;QI Jin-chun(Department of Urology,The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China;Hebei Medical University,Shijiazhuang,Hebei 050000,China;Department of Urology,Xingtai People's Hospital,Xingta,Hebei 054400,China;Department of Urology,Guantao Hospital of Traditional Chinese Medicine,Handan,Hebei 057750,China)

机构地区：[1]河北医科大学第二医院泌尿外科,河北石家庄050000 [2]河北医科大学,河北石家庄050000 [3]邢台市人民医院外科,河北邢台054400 [4]馆陶县中医医院泌尿外科,河北邯郸057750

出　　处：《中华男科学杂志》2025年第3期222-225,共4页National Journal of Andrology

基　　金：河北省医学科学研究课题(20210026)。

摘　　要：目的:探讨在高频超声引导下手法复位联合手术与单纯手术两种治疗模式的差异,为睾丸扭转的及时诊治提供新的依据。方法:回顾2015年1月至2022年5月确诊为单侧睾丸扭转且扭转时间在48 h内的患者共134例,在患者年龄分布、扭转时间、扭转角度方面进行统计和分析。结果:共纳入134例睾丸扭转患者,发病年龄的中位数为15(13,19)岁,发病至就诊时间的中位数为15(8,25)h,扭转角度的中位数360°(180°~1080°)。134例患者中,睾丸切除组21例,睾丸保留组113例,两组在年龄分布上无明显差异(P>0.05);扭转时间越长、扭转角度越大的患者,睾丸切除率越高(P<0.05)。134例患者中,手法复位联合手术组33例,单纯手术组101例。根据临床实际情况,排除扭转时间>24 h及扭转度数>720°的患者后,入选手法复位联合手术组28例,单纯手术组68例,手法复位联合手术组睾丸切除患者1例(3.6%),单纯手术组睾丸切除患者7例(10.3%),单纯手术组睾丸切除率高于手法复位联合手术组,但差异无统计学意义(P>0.05),考虑与本研究入选样本量较少有关。结论:社会层面普及睾丸扭转相关知识,缩短就医时间,同时急诊手术前合理行手法复位有助于降低睾丸切除率。Objective:To investigate the differences between high-frequency ultrasound-guided manual detorsion combined with surgery(MD+S)and surgery alone in the treatment of testicular torsion,and to provide some new evidence for the timely diagnosis and treatment of the disease.Methods:We retrospectively analyzed the clinical data on 134 cases of unilateral testicular torsion within 48 hours treated in our hospital by MD+S or by surgery alone from January 2015 to May 2022.We statistically analyzed the age distribution,and duration and degrees of testicular torsion,followed by comparison between the two groups.Results:In the 134 cases,the median age of onset was 15(13-19)years old,the median onset-to-visit time was 15(8-25)hours,and the median degree of torsion was 360°(180°-1080°).Of the total number of patients,21 underwent testicular excision and the other 113 were treated with the testis preserved,with no statistically significant difference in age distribution between the two groups(P>0.05),and a higher rate of testis resection in those with longer duration and greater angle of torsion(P<0.05).Totally,33 of the patients were assigned to the MD+S group and 101 to the surgery alone group.According to the actual clinical conditions and excluding those with torsion time longer than 24 hours and torsion angle greater than 720°,28 of the patients underwent ultrasound-guided MD+S(with 1 case of testis resection,3.6%),and 68 received surgery alone(with 7 cases of testis resection,10.3%).The rate of testis resection was higher in the surgery alone than that in the MD+S group,but with no statistically significant difference between the two groups(P>0.05),which was considered to be related to the small sample size in this study.Conclusion:The popularization of testicular torsion knowledge can shorten the onset-to-visit time,and reasonable manual detorsion before emergency surgery can reduce the rate of testis resection.

关 键 词：睾丸扭转 手法复位 手法复位联合手术 

分 类 号：R697.22[医药卫生—泌尿科学]