睾丸扭转19例的诊治

Experience in the diagnosis and treatment of the testicular torsion(report of 19 cases)

目的总结睾丸扭转的诊断与治疗体会,提高睾丸扭转的诊治水平。方法回顾性分析19例睾丸扭转患者的临床资料,患者年龄8~42岁,平均19.6岁。左侧14例,右侧5例。发病至确诊时间3 h^7 d。结果初诊误诊7例。4例发病时间短或扭转程度轻经手术复位而保留睾丸,其余15例因睾丸已坏死而予以切除。手术同时均行对侧睾丸探查固定。13例术前行彩色多普勒血流动态显象(CDFI)检查,1例发病4 h检查睾丸血流正常,第2天复查无血流,其余12例均提示睾丸无血流或血流减少。结论CDFI检查是诊断睾丸扭转的可靠方法,早期诊断和及时治疗是提高疗效的关键,在怀疑有睾丸扭转时,应及时手术探查。

Objective To summarize the the diagnosis and treatment of the testicular torsion and to improve its managment. Methods The clinical data of 19 cases （ mean age, 19.6 years ; age range, 8 - 42 years） of the testicular torsion were analysed retrospectively. Among them, 14 cases had the lesion on the left testicle, and 5 cases on the right. The time from onset to a definite diagnosis was 3 h - 7 d. Results 7 cases were not diagnosed rightly in the first time. There were 4 testicles with short time or incomplete torsion salvaged by operative detorsion and 15 testicles removed for testicular necrosis, orchiopexy was performed in another side all of the cases. Color Doppler flow imaging using in 13 cases preoperation showed that 12 testicles had no or little blood, 1 testicle had normal blood within 4 h and next day no blood. Conclusion Color Doppler flow imaging is a reliable way in diagnosis of the testicular torsion. Early diagnosis and timely treatment are the key of improving therapeutic effect. The operative examination is necessary when testicular torsion is high suspected.