闭合性阴囊损伤的诊断及手术与保守治疗效果的比较

The diagnosis and treatment of blunt scrotal trauma

目的 :提高闭合性阴囊损伤的诊断和治疗水平。方法 :回顾性分析闭合性阴囊损伤 6 2例患者的临床资料 ,比较其手术和保守治疗的效果。结果 :手术治疗组 2 8例 ,2 5例获得随访 3～ 12个月 ,其中 2 3例 0 .5～ 3个月时症状完全消失 ,仅 2例阴囊坠痛持续 3个月以上 ,未见睾丸萎缩 ;保守治疗组 34例获得随访 6～ 6 0个月 ,2 0例 0 .5～ 3个月、6例 3～ 6个月、4例 6～ 12个月时症状完全消失 ,4例症状持续 1年以上 ,其中有 5例睾丸萎缩。结论 :闭合性阴囊损伤除小的单纯性阴囊血肿可保守治疗外 ,对大的、增长较快的血肿均应手术探查 ,清除血肿 ,充分引流 ,修补破裂的睾丸 。

Purpose:To improve the diagnosis and treatment of blunt scrotal trauma.Methods:Data of 62 cases with blunt scrotal trauma was analyzed retrospectively. Results:The number of operation group and conservative treatment group were 28 and 34, respectively. In the operation group, 25 cases were followed for 3 to 12 months, the symptoms of 23 cases lasted for 0.5 to 3 months and the remaining 2 cases more than 3 months, there was no testicular atrophy in this group. In the conservative treatment group, 34 cases were followed for 6 to 60 months, the numbers of patients whose symptoms lasted for 0.5 to 3, 3 to 6, 6 to 12 and more than 12 months were 20, 6, 4 ,4, respectively. 5 testicular atrophy cases were noted in this group. Conclusions:In the blunt scrotal trauma patients, the small scrotal hematoma can be treated with conservative methods and the big hematoma, especially whose bulk is increasing quickly, should be treated surgically to avoid testicular atrophy and dysfunction in spermatogenesis.