小儿隐睾扭转的诊治体会

Experience of diagnosis and treatment of cryptorchidism torsion in children

目的：探讨小儿隐睾合并扭转的临床诊治经验。方法回顾性分析2008年7月至2013年12月我们收治的14例小儿隐睾合并睾丸扭转病例的临床资料，其中左侧9例，右侧5例；左侧9例中，2例为双侧隐睾；右侧5例中，1例术中及术后病理检查证实为隐睾合并睾丸成熟畸胎瘤。14例均为单侧隐睾扭转。患儿年龄4岁至11岁5个月，平均3．1岁。结果14例患儿中，11例行扭转坏死睾丸切除术，3例行扭转睾丸复位＋下降固定术，患儿均同期行健侧睾丸固定术或健侧睾丸下降固定术。术后经2个月至5年随访，11例睾丸切除患儿健侧睾丸发育良好，血清睾酮水平正常；3例睾丸下降固定术患儿中，2例睾丸发育良好，1例合并睾丸畸胎瘤患儿经保睾手术后患侧睾丸发育较小，无肿瘤复发。结论早期诊断和及时手术治疗是提高隐睾并扭转患儿睾丸存活率的关键。

Objetive To investigate the experience of diagnosis and treatment of cryptorchidism torsion in children. Methods A retrospective analysis was performed on 1 4 children with cryptorchidism torsion from July 2008 to December 201 3 in our hospital.of 1 4 cases,9 were left-side,5 right-side.There were 2 cases with double cryptorchidism in the 9 cases of left side,there were 1 cases with testicular mature teratoma in the 5 cases of right side.All 1 4 cases were unilateral cryptorchidism torsion.The patients aged 4 months to 1 1 years old and 5 months,with an average age of 3.1 years. Results Orchiectomy of testicular necrosis was per-formed in 1 1 cases,testicular torsion reset＆amp;drop fixation was performed in 3 cases.contralateral testicular fix-ation was performed to all patients.All cases were followed up for 2 months to 5 years.The contralateral testis had good blood supply and development in the 1 1 patients with orchiectomy,and their serum testosterone level was normal;2 of the 3 patients with testicular descent fixation had normal testicular development,the testicular depauperation was happened in the patient with testicular mature teratoma,with higher testicular hardness com-paring with the other side.No case of contralateral testicular torsion occurred. Conclusion Early diagnosis and prompt surgical treatment was the key to improve the testicular survival rate of cryptorchidism torsion.