隐睾并睾丸扭转临床分析并文献复习

Clinical Analysis and Literature Review of Cryptorchidism Combined with Testicular Torsion

目的探讨隐睾并睾丸扭转的发生机制、临床特点及诊断、预后情况。方法对2010年1月—2016年9月维普中文生物医学期刊库有关隐睾并睾丸扭转相关文献中隐睾并睾丸扭转13例及解放军254医院收治的隐睾并睾丸扭转1例的临床资料进行回顾性分析总结。结果本组双侧隐睾发生左侧睾丸扭转2例;左侧隐睾发生同侧睾丸扭转5例;右侧隐睾7例,其中发生右侧扭转5例,先发生右侧扭转后又发生左侧扭转2例。9例出现患侧腹股沟区疼痛;2例右下腹痛伴恶心、呕吐;2例左睾丸疼痛,向大腿根部放射;1例22月龄患儿表现为哭吵不安,拒乳,伴腹股沟区肿块。14例中13例行睾丸切除,睾丸切除率92.86%;1例成功挽救睾丸。结论临床遇及以腹股沟区疼痛、肿块为主诉就诊,且查体发现同侧阴囊空虚,接诊医师怀疑发生隐睾并睾丸扭转患者时,应早期积极进行彩色多普勒超声检查,并尽早进行腹股沟区探查,以明确诊断,最大可能挽救睾丸。

Objective To investigate pathogenesy, clinical characteristics and conditions of diagnosis, treatment and prognosis of cryptorehidism combined with testicular torsion. Methods Clinical data of 13 patients with cryptorchidism combined with testieular torsion from VIP database during January 2010 and September 2016 and 1 patient with cryptorchidism combined with testicular torsion in our hospital was retrospectively analyzed. Results Among the 14 patients, 2 patients with bilateral eryptorchidism had left testicular torsion; 5 patients with left cryptorchidism had homolateral testicular torsion; 5 patients had right testicular torsion in 7 patients with right eryptorchidism ; 2 patients had right and left testieular torsion in turn. Inguinal region pain in affected side was found in 9 patients; right lower quadrant pain associated by nausea and vomiting was found in 2 patients ; 2 patients had left testis pain and then radiated to femoral crotch area ; a child with 22 months old had cry- ing, unpeaceful and refusing lactation with inguinal region mass. Orchidectomy was performed in 13 patients among the 14 patients, and the orehidectomy rate was 92.86% ; I patient was successfully retrieved the testis. Conclusion When elinlcians suspect the patients with eryptorchidism combined with testicular torsion, who have inguinal region pain, mass and homolateral serotal empty, color doppler ultrasonography and inguinal region detection should be performed as early as possible in order to confirm the diagnosis and retrieving testis as most as possible.