超声及腹腔镜探查诊断小儿未触及睾丸

Ultrasound and laparoscopy in diagnosis of nonpalpable testis in children

目的探讨超声及腹腔镜探查诊断小儿未触及睾丸的价值。方法对35例未触及睾丸患儿行常规超声检查,对超声于腹腔外未探及患侧睾丸者行腹腔镜探查术。分析检查结果,比较睾丸缺如、睾丸残余与单侧隐睾患儿健侧睾丸体积差异。结果 35例未触及睾丸患儿中,超声探及14例(17个)隐睾(13个腹内型和4个腹外型)、3例腹外型睾丸缺如、2例腹外型睾丸残余及2例异位睾丸,总检出率为60.00%(21/35)。对25例患儿行腹腔镜探查,发现17例(19个)腹内型隐睾、6例睾丸缺如(5例腹内型和1例腹外型)、2例腹内型睾丸残余,腹腔镜探查对腹内型未触及睾丸检出率为100%(24/24)。睾丸缺如、睾丸残余患儿健侧睾丸体积大于单侧隐睾患儿健侧睾丸体积(P均<0.05)。结论联合应用超声和腹腔镜对诊断小儿未触及睾丸具有重要应用价值。

Objective To explore the value of ultrasound and laparoscopy in diagnosis of nonpalpable testis in children. Methods A total of 35 children with nonpalpable testis underwent routine ultrasound examination, and then laparoscopy was performed for patients whose nonpalpable testis were failed to be explored at extra-abdominal area by ultrasound. The diagnostic outcomes were analyzed. The volume of testis on the unaffected side was compared among testicular agenesis, testicular residual and unilateral cryptorchidism. Results Ultrasound explored 14 cases of cryptorchidism （17 cryptorchid- ism）, including 13 intra-ahdominal and 4 extra-abdominal type, 3 cases of extra-abdominal testicular agenesis, 2 cases of extra-abdominal testicular residual and 2 cases of ectopic testis. The detection rate of ultrasound for nonpalpable testis was 60.00% （21/35）. Laparoscopy was performed in 25 cases, which detected 17 cases of intra-abdominal cryptorchidism （19 cryptorchidism）, 6 cases of testicular agenesis including 5 intra-abdominal and 1 extra-abdominal type, 2 cases of intra- abdominal testicular residual. The detection rate of laparoscopy for intra-abdominal nonpalpable testis was 100% （24/24）. The volume of testis on the unaffected side was smaller in unilateral cryptorchidism patients than that in testicular agenesis and testicular residual patients （both P〈0. 05）. Conclusion Combination of ultrasound and laparoscopy is of great value in diagnosis of nonpalpable testis in children.