重庆地区451例睾丸扭转的临床特征分析

Analysis of clinical features of 451 cases of testicular torsion in Chongqing

目的:了解重庆地区睾丸扭转的流行病学特点及诊治现状。方法:采用病案资料回顾性分析法,对重庆市50家医疗机构2012年1月至2016年12月间451例睾丸扭转病例进行调查,结果采用统计描述和Cochran-Armitage趋势检验。结果:疾病流行病学特点:发病年龄以18岁以下为主(65.9%),季节以冬季常见(43.2%),首发症状主要为阴囊疼痛(69.6%)和睾丸疼痛(25.7%),左右侧睾丸比为1.79∶1,扭转类型以鞘膜内型常见(88.1%)。疾病诊治方面:首诊误诊率为32.8%,医生职称和医疗机构等级越低,误诊率越高;发病至就诊时间越长,睾丸切除率越高;差异有统计学意义。患者未及时就诊原因主要为患方未重视(52.6%)及首诊误诊(45.5%)。结论:睾丸扭转诊治水平有待提高,提高基层医院、初级医务人员的诊治水平及公众对该病的认识是提高睾丸挽救率的关键。

Objective :To investigate the epidemiological characters and treatment status of testicular torsion in Chongqing.Methods: Retrospective review and questionnaire survey were used to investigate 451 patients diagnosed with testicular torsion from January 2012 to December 2016 in 50hospitals in Chongqing.The data were analyzed by descriptive statistic and Cochran-Armitage Trend test.Results:The epidemiological characters of the disease included that the disease mainly attacked individuals below 18 years old (65.9%),the onset usually occurred in winter(43.2%),the preliminary symptoms were scrotal pain(69.6%)and testis pain(25.7%), the ratio of left testis to right was 1.79:1and the torsion style was more common in the sheath(88.1.%).The misdiagnosis rate at initial diagnosis was 32.8%.The lower of the doctor's qualifications and institution's level,the higher of the misdiagnosis and the longer of the duration from the onset of disease to clinic visit,the more opportunity of testicle loss and the differences were statistically significant.The reasons for prolonged treatment mainly included the insufficient attention paid by patients and their families,as well as misdiagnosis by doctors at initial evaluation.Conclusion:There is a need to improve the diagnosis and therapy capabilities of doctors for testicular torsion,especially for those in primary hospitals and with junior degree.Meanwhile,enhancing the disease understanding of the public is also important.