外伤性睾丸破裂16例诊治体会

Traumatic rupture of testicle (report of 16 cases)

目的探讨睾丸破裂的诊治及预后。方法睾丸破裂16例,通过病史、体检,11例通过彩超确诊,3例彩超检查后可疑破裂进一步行CT扫描确诊,另有两例通过手术探查确诊。全部予以手术治疗,13例行睾丸修补,3例行睾丸切除。结果无严重并发症及死亡病例发生,随访10个月～4年,其中有2例单侧损伤病人行睾丸修补后出现双侧睾丸萎缩,一例单侧切除后对侧发生萎缩,一例双侧严重损伤的病人生殖功能明显下降,但所有病人雄激素水平基本正常。结论彩超及CT检查是判断睾丸损伤程度及病情变化的重要方法,积极早期手术探查可最大限度保留睾丸组织,减少并发症发生。

Objective To investigate the diagnosis ,treatment and prognosis of testicular injury. Methods Total of 16 cases with testicular rupture were enrolled in the study. Of them, 11 patients were confirmed by traumatic history, physical examination and colour duplex Doppler Ultrasonography（US） , 3 patientss by CT scanning after US examination, and the other 2 patients by operative exploration. Thirteen patients received testicular repair and 3 pa- tients underwent orchidectomy. Results No severe complications and death occurred. After 10 months to 4 years follow up. Two patients treated with the repair were found to have bilateral orchiatrophy, and one patient treated by orchidectomy had unilateral orchiatrophy at opposite side. One Reproductive function of one patient was significantly decreased for bilateral severe injuries. However, androgen level of all patients were normal in general. Conclusion Colour duplex Doppler Ultrasonography and CT scanning are important tools to evaluate the severity degree of testicular injury. Early and timely operation can conserve more testicular tissues utmostly and reduce complications.