流行性腮腺炎合并睾丸炎的临床分析

Clinical Study on Mumps Orchitis

目的:通过分析流行性腮腺炎(Mumps)并发睾丸炎时的临床特征,为相关疾病的诊断和治疗提供依据。方法:回顾性分析吉林省肝胆病医院2010年8月～2012年8月收治的21例Mumps合并睾丸炎的患者的临床资料及辅助检查。结果:合并睾丸炎占腮腺炎发病总数的30.88%,占男性Mumps患者的38.89%;发病年龄12～32岁,其中12～17岁3例(14.29%),18～25岁15例(71.43%),26～32岁3例(14.29%)。患者有Mumps患者接触史,疫苗接种缺如。21例患者中,20例是继发烧、腮腺肿大后1周左右出现睾丸肿痛,1例以睾丸炎为首发症状。单侧肿痛较多见;彩色超声检查显示患侧睾丸增大,呈炎症性改变,可同时伴有少量鞘膜积液,精索增粗。给予抗病毒、对症综合治疗后均痊愈出院。结论:18～25岁男性Mumps感染者易并发睾丸炎,多数病例存在二次发热,即在腮腺肿痛渐消的情况下再度发热,出现睾丸肿痛。所以对于18～25岁男性Mumps患者,不应以腮腺肿胀减轻而视为病情好转,建议应延长临床观察时间,从发病开始不少于3周。

Objective ：To investigate clinical feature, and the experience or lessons for the treatment of Mumps orchitis. Methods ：The clinical features of 21 patients with Mumps orchitis in our hospital from august 2010 to august 2012 were analyzed retrospectively. Results： Mumps orchitis accounted for 30.88% of all mumps, males with 38.89%, onset age between 12 - 32, 12 - 17 in 3 cases （14.29%） , 18 -25 in 15 cases （71.43%）, 26-32 in 3 cases （14.29%）, and all patients with mumps contact history, no vaccination. 20 patients testicular swelling and pain appeared after a week or so,followed parotid gland enlargement and fever, 1 case with orchitis as initial symptom. Unilateral swelling mostly, Color ultrasonography showed ipsilateral testicular enlargement, inflammatory change, accompanied by a small amount of hydrocele, spermatic cord thickening. All patients were cured and discharged through combined treatment. Conclusions： Mumps orchitis is susceptible to 18 -25 male patients. Most of the cases have occurred two times in fever, that fever again after the fever subsided, parotid swelling fading, at the same time with testicular swelling and pain. As a result, 18 -25 male Mumps patients should not be to parotid gland swelling reduced and think improved. The clinical observation time should be extended no less than 3 weeks from illness onset.