睾丸扭转的诊治(附59例报告)

Diagnosis and treatment of the testicular torsion(Report of 59 cases).

目的 探讨睾丸扭转的诊治。方法 回顾性分析59例睾丸扭转患者的临床资料。结果 1例为腹腔内恶变隐睾扭转,余58例(59次)发病时中位年龄18.5岁,均无发热,50例次在夜间或剧烈运动后发病。4例手法复位成功。1例手法复位后再次扭转,拒行手术效睾丸萎缩。2例明确睾丸已坏死未手术洽疗,患睾逐渐萎缩。接受手术探查的52例中有15例睾丸存活,其中发病超过24d的1例,不到10h11例。结论 青少年夜间或运动后突发急性睾丸痛应该警惕扭转的可能,必要时紧急手术探查,手法复位可尝试应用。

Objective To investigate the diagnosis and treatment of testicular torsion. Methods The clinical materials of 59 patients with testicular torsion were analysed retrospectively. Results The torsion of intraabdominal malignant testis occurred in one patient,and the medial age of the others was 18.5 years.4 patients received manual detorsion successfully.but retorsion and atrophy of the testis occurred in one patient. 2 patients with necrotic testis were treated medically without infection. 15 of the 52 patients received exploration gained gonad savatage.and the symptoms of 11 patients among them lasted less than 10 hours while only one of them greater than 24 hours. Conclusion When a sudden acute scrotum pain without fever occurred in an adolescent,the testicular torsion must be considered. If necessary,emergent surgical exploration should be performed,and the manual detorsion could be attempted pre-operation.