睾丸扭转的诊治（附46例报告）

Diagnosis and treatment of testicular torsion （report of 46 cases）

目的：提高睾丸扭转的诊治水平。方法：对46例睾丸扭转患者的临床资料进行总结：46例平均年龄17岁，左侧31例占67．4％，发病至确诊时间3小时～11天。46例均有睾丸或下腹部绞痛症状，Prehn征阳性28例；彩色多普勒超声显示29例睾丸、附睾血流减少或消失。结果：8例12小时以内手法复位或手术者，睾丸均存活；6例12～24小时手术者，3例睾丸存活；31例超过24小时手术者，仅1例睾丸存活；2例未手术。结论：彩色多普勒超声有助于睾丸扭转的早期诊断，应作为诊断该疾病的首选检查方法。早期诊断、及时治疗是提高疗效的关键。

Objective： To improve the levels of diagnosis and treatment of testicular torsion. Methods： The clinical data of 46 cases of testicular torsions were summarized and analyed. Mean age of the patients was 17years, with 67. 4% being in the left side, the elapse of time from onset to a definite diagnosis was 3 h～11d. All the 46 cases had the essential clinical symptom of colic in testis or bythus, and 28 cases had the positive Prehn＇s sign. Color Doppler ultrasonography （CDU） showed that the blood supply in testis was reduced clearly or disappeared. Results： Eight cases who received operation within 12 hours from attack time had testicles survival Of 6 cases who had operation within 12 to 24 hours from attack time 3 had testicles survival Of 31 cases who had operation more than 24 hours from attack time only 1 had testicles survival. Two cases had no operation. Conclusions： It is helpful to get diagnosis for early testicular rtorsion by color Doppler ultrasonography and it should be considered the primary diagnostic approach for scrotal emergencies. Early diagnosis and timely treatment are key of improving therapeutic effect.