小儿睾丸扭转的诊断与治疗

目的提高对小儿睾丸扭转的临床诊断和治疗水平。方法回顾性分析42例睾丸扭转的临床资料,年龄4～15岁,平均8.5岁。左睾丸27个,右睾丸15个。初诊时间<6h10例,6～24h26例,6例超过24h。初诊确诊为睾丸扭转24例,延误诊断18例(本院7例,外院11例)。结果8例发病后6h就诊者,给予手法复位成功;34例发病时间>6h者手术探查,18例手术探查睾丸已坏死,而行睾丸切除。结论彩色多普勒超声是首选辅助检查方法。提高首诊诊断正确率将有助于扭转睾丸的获救。主张尽早手术及预防性对侧睾丸固定。

A report of 42 patients with torsion of testis:Diagnosis and treatment

Objective To investigate the diagnosis and treatment of testicular torsion.Methods The data of 42 patients with testicular torsion were analyzed retrospectively.Results The patients' ages ranged from 4 to 15 years (mean: 8.5 yrs) with 27 left testis and 15 right involved. Initial correct diagnosis was made in 24 patients and delayed in 18 patients (7 in our institution; 11 in other hospitals). Eight of 10 patients with history of less than 6 hours were cured by manual detorsion. For the remaining 34 patients with history longer than 6 hours, 16 were cured by operative detorsion and 18 by orchiectomy for testicular necrosis.Conclusions Color Doppler ultrasound is useful for the diagnosis of testicular torsion and can serve as a chief adjuvant diagnostic method. Early accurate initial diagnosis is the key to improve viability of the testicles, The contralateral testicle should be treated with orchidopexy.