彩色多普勒超声预测睾丸扭转后存活力的价值

The value of color Doppler ultrasound in the predicting of the viability after testicular torsion

目的:探讨彩色多普勒超声预测睾丸扭转后存活力的临床价值。方法:对16例睾丸扭转患者彩色多普勒声像及临床资料进行回顾性分析,将术前扭转睾丸不同彩色多普勒声像分为a、b、c、d 4种类型;术中扭转睾丸的不同情况,将其存活力分为A^D级,其中将A^C级存活力睾丸保留,D级存活力睾丸切除;将随访的睾丸存活力分为Ⅰ~Ⅲ级,Ⅰ~Ⅱ级睾丸存活,Ⅲ级睾丸萎缩。结果:16例睾丸扭转中,10例手术复位保留,6例手术切除。手术复位中睾丸存活9例,术前声像为a型3例,b型2例,c型4例;术中睾丸存活力为A级1例,B级3例,C级5例;远期睾丸存活力为Ⅰ级2例,Ⅱ级7例。手术复位组中萎缩1例,术前声像分级为d型,术中睾丸存活力为D级,远期睾丸存活力为Ⅲ级。手术切除6例术前声像为c型1例,d型5例;术中睾丸存活力均为D级。结论:彩色多普勒超声检查睾丸扭转并能够预测复位后睾丸的存活力,为临床手术方案选择提供重要参考依据,是挽救扭转睾丸,提高其存活力的关键。

Objective： To explore the value of color Doppler uhrasound in the predicting of the viability after testicular torsion. Methods ：The clinical data of color Doppler uhrasound flow imaging in 16 cases with testicular torsion were retrospectively analyzed. The testicular torsion were divided into type a, b, c and d according to the color Doppler ultrasound flow imaging before operation. According to intraoperative testicular torsion, testicular viability was divided into level. A, B, C and D The testis with level A to C viability could be saved,the testis with level D viability could not be saved. The testicular viability during the period of following-up could be divided into gradeⅠ to Ⅲ, the testis with grade Ⅰand Ⅱ survived, and grade Ⅲ atrophied. Results： Among 16 cases with testicular torsion,the testis in 10 cases and 6 cases were restored and resected, respectively. Nine cases with restoration survived, their preoperative uhrasonography included type a in 3 cases,type b in 2 cases and type c in 4 cases, their intraoperative testicular activity included level A in 1 case,level B in 3 cases and level C in 5 cases, their forward testicular viability included grade Ⅰ in 2 cases and Ⅱ grade in 7 cases. One testis with restoration atrophied, its preoperative uhrasonography, intraoperative testicular activity and forward testicular viability were type d, level D and grade Ⅲ, respectively. Amony 6 cases with testicular resection, the type c and d of preoperative ultrasonography were 1 case and 5 cases, respectively, their intraoperative testicular activity were level D. Conclusions： Color Doppler ultrasound of testicular torsion can predict the testis viability, which provide an important reference for clinical surgery program,and is the key to rescue testicular torsion and improve its viability.