睾丸扭转45例临床分析

Clinical analysis of 45 cases of testicular torsion

[背景]探讨睾丸扭转的发病原因及诊断与治疗方法.[病例报告]回顾性分析2012—2021年间收治的45例睾丸扭转患者的临床资料,分析发病原因及与睾丸保留的相关因素.结果见,本组睾丸扭转的发病存在季节相关性(χ^(2)=5.260,P<0.05),冬、春季好发,原因认为与冬春季温差大有关系.睾丸扭转手术方式的选择与扭转时间(P<0.01)及扭转角度(P<0.05)具有相关性.[讨论]冬、春季节出现突发性单侧阴囊肿痛时可考虑发生睾丸扭转的可能,建议结合辅助检查进行诊断,必要时行短期多次睾丸附睾彩色超声波检查以防止误诊,及时行手术探查明确诊断,术中根据Arda分级评估睾丸功能以选择相应术式,早期行手术治疗可明显提高睾丸保留率.

BACKGROUND Through the analysis of the diagnosis and treatment of testicular torsion,the etiological characteristics of testicular torsion should be clarified,and the diagnosis and treatment level and testicular retention rate should be improved.CASE REPORTS A retrospective study was made on 45 cases of testicular torsion treated from 2012 to 2021,and the etiological characteristics of testicular torsion and the relationship between testicular retention and related factors were analyzed statistically.The main etiological characteristics of testicular torsion in Yanbian area were related to season(χ^(2)=5.260,P<0.05).It was easy to induce testicular torsion in winter and spring because of the large temperature difference in winter and spring.The choice of operation mode of testicular torsion was significantly correlated with torsion time(P<0.01)and torsion angle(P<0.05).DISCUSSION When sudden unilateral scrotal swelling and pain occur in winter and spring,the possibility of testicular torsion should be considered,and the safest diagnosis method is physical examination combined with auxiliary examination.If necessary,testis and epididymis color Doppler ultrasound can be performed for several times to prevent misdiagnosis.As soon as the diagnosis is confirmed,the testicular function should be evaluated according to Arda classification in order to select the appropriate surgical procedures.Early surgical treatment can significantly improve the testicular retention rate.