39例睾丸扭转的诊断与治疗并文献复习

The diagnosis and treatment of testicular torsion ： 39 cases report and review of the literature

目的 提高睾丸扭转的诊断与治疗水平.方法 回顾性分析2007年1月～ 2013年10月间39例睾丸扭转患者的住院病例资料.结果 30例患者早期被误诊为睾丸附睾炎.39例均行阴囊彩超检查,其中9例提示睾丸血供明显减少,30例提示睾丸血供消失.并急诊行阴囊探查术,术中发现30例患侧睾丸坏死,行患侧睾丸切除＋对侧睾丸固定术;9例复位扭转睾丸后血供好转或者恢复,行睾丸复位固定术＋对侧睾丸固定术.术后35例获随访,随访时间3 ～72个月,其中3例复位睾丸出现不同程度萎缩,所有患侧睾丸及健侧睾丸未再次发生扭转.结论 睾丸扭转早期容易误诊为睾丸、附睾炎,阴囊彩超有助于诊断.一旦明确或者高度怀疑睾丸扭转,应急诊行阴囊探查术,挽救扭转的睾丸.

Objectives To investigate the diagnosis and treatment of testicular torsion.Methods The clinical data of 39 cases of testicular torsion were analyzed retrospectively from January 2007 to October 2013.Results 30 cases were misdiagnosed as epididymis orchitis in early stage.39 cases were all operated with Colour Doppler ultrasound,demonstrated the reduction of the testicular blood supply in 9 cases and loss of blood supply in 30 cases.All cases were given emergency surgical exploration,and 30 cases were found to be testicular necrosis by performed ipsilateral orchiectomy with contralateral orchidopexy while the other 9 cases were performed ipsilateral testis reduction and fixation and contralateral orchidopexy that got a recovery.35 cases were followed up ffrom 3 months to 72 months,and 3 cases were testicular atrophy of reductive testis in different degree,and no recurrent cases.Conclusions Testicular torsion is easily misdiagnosed as testitis or epididymitis in early stage.Colour Doppler ultrasound is useful for diagnosis.Testicular torsion needs emergency surgical exploration to save the torsional testis once it is confirmed or deeply suspected as testicular torsion.