精索扭转的诊断及治疗研究(附54例报告)

Diagnosis and Treatment of Testicular Torsion(Report of 54 Cases)

目的:总结精索扭转的早期诊断及治疗方法,提高精索扭转的诊治水平。方法:对54例精索扭转患者的临床资料进行回顾性分析。结果:对54例试行手法复位成功10例,失败3例;手术探查44例,20例予以保留睾丸,24例行睾丸切除,12例未行对侧睾丸预防性固定,随访有1例发生对侧精索扭转,32例行对侧睾丸预防性固定,未见精索扭转发生。结论:对本病应保持足够的警惕与认识,并通过详细地询问病史细致地体格检查,适当地辅助检和及时地手术探查来诊断本病;睾丸毁损与扭转的时间密切相关,延迟就诊是睾丸丢失的重要原因,临床高度怀疑时应及早手术探查。常规预防性固定健侧睾丸不是很必要。

Objective：To summarize and improve the diagnosis and treatment of testicular torsion. Methods： The clinical data of 54 cases of testicular torsion were retrospectively analyzed. Results： Manipulative reduction was successful inl0 patients but 3 failed. The remaining 44 patients received operation and 20 of them retained their testicle while 24 patients lost one testicle. Among the 12 patients who did not have the prophylactic contra lateral orchidopexy, one experienced testicular torsion. No testicular torsion occurred among the 32 patients who underwent the prophylactic contra lateral orchidopexy. Conclusions： Clinicians should pay much attention to testicular torsion. Patient history, medical examination and operative exploration are helpful in diagnosis of this disease. Testicular damage is closely related with the torsion time, delayed treatment is an important reason for missing testicle. Clinicians highly suspected the operative exploration should be done as early as possible. Prophylactic contra lateral orehidopexy is not always necessary.