儿童睾丸扭转的早期鉴别诊疗

Early differential diagnosis and treatment of testicular torsion in children

目的探讨儿童睾丸扭转的鉴别诊疗方法。方法回顾性分析2006～2014年因睾丸扭转在我科接受手术治疗84例儿童患者的临床资料,总结儿童睾丸扭转的临床诊断及治疗方法。结果 84例患儿中,睾丸或腹部疼痛72例（86%）,提睾肌反射消失69例（82%）,阴囊水肿68例（81%）。经急诊多普勒超声检查可见肿大、缺血的睾丸患者72例,术中确诊12例。因睾丸坏死行睾丸切除术29例（35%）,术后睾丸保留55例（65%）。结论对于睾丸或腹部疼痛、提睾肌反射消失或阴囊水肿的儿童及青少年患者,应及时对患者外生殖器进行仔细检查,借助超声检查或阴囊探查术进行确诊,并及时手术,尽量避免睾丸扭转漏诊或误诊的发生。

Objective To explore the differential diagnosis and treatment of testicular torsion in children.MethodsClinical data of 84 children patients with testicular torsion who underwent surgery during 2006 to 2014 were retrospectively analyzed.Results Of all 84 cases,testicular or abdominal pain occurred in 72 cases（86%）,cremaster reflex disappearance occurred in 69 cases（82%）,and scrotal edema occurred in 68 cases（81%）.Doppler ultrasonography found swelling and ischemic testis in 72 cases,12 of which were confirmed in operation.Orchiectomy was performed in 29 patients（35%）with testicular necrosis,and 55 cases（65%）had testis reserved.Conclusions For children and adolescents with testicular or abdominal pain,cremaster reflex disappearance,or edema of the scrotum,the external genitalia should be carefully checked.Ultrasound or scrotal exploration should be used for diagnosis.Timely operation is necessary to avoid missed diagnosis or misdiagnosis of testicular torsion.