睾丸扭转诊治经验及误诊分析

Experience of Diagnosis and Treatment of Testicular Torsion and Misdiagnosis Analysis

[目的]总结睾丸扭转的诊治经验及误诊原因,减少睾丸的切除率,提高睾丸扭转的诊治水平.[方法]对2005年3月至2011年8月期间51例睾丸扭转病人的临床资料进行分析.[结果]51例病人中,首诊确诊为睾丸扭转者17例,延误诊断34例（66.7%）.仅4例手法复位成功,其余47例急诊行手术探查,其中15例睾丸复位成功,并用＂睾丸鞘膜翻转法＂固定患侧及健侧睾丸;32例行睾丸切除,健侧＂三角固定法＂固定.[结论]睾丸扭转的早期诊断尤其重要,及时手术探查是降低误诊率的关键.常规应用＂三角固定法＂固定对侧睾丸,可预防性避免再次发生扭转.

[Objective]To summarize the experience of diagnosis and treatment of testicular torsion and misdiagnosis reasons in order to reduce testicular resection rate and improve the level of diagnosis and treat- ment of testicular torsion. [Methods] The clinical data of 51 patients with testicular torsion from March 2005 to August 2011 were analyzed. [Results]Among 51 patients, there were 17 patients（33.3%） with first final diagnosis and 34 patients（66.7 %） with delayed diagnosis. Only 4 cases underwent manual reduction success- fully. The remaining 47 cases underwent emergency surgical exploration. Of 47 cases, 15 cases underwent tes- ticular reset successfully which ipsilateral and contralateral testis were fixed by ＂hydrocele flip method＂ and 32 cases underwent orchiectomy Which contralateral testis was fixed by ＂triangle fixation method＂. [Conclusion] Early diagnosis of testicular torsion is particularly important and timely surgical exploration is the key to re- duce the rate of misdiagnosis. Routine use of ＂triangle fixation＂ for fixing contralateral testis can avoid the re- currence of testieular torsion.