28例睾丸扭转超声诊断及临床治疗分析

Ultrasound diagnosis and clinical treatment analysis of 28 cases of testicular torsion

目的分析早期睾丸扭转诊断及诊治效果,提高睾丸扭转存活率。方法选取我院2011年2月～2017年4月28例睾丸扭转患者,入院前均行彩色多普勒超声检查,观察患者睾丸实质回声及血流情况,并对扭转患者的临床治疗情况进行回顾分析。结果 28例患者中,左侧16例,右侧12例;超声诊断睾丸完全无血流信号15例,12例睾丸血流明显减少,1例睾丸血流无改变。4例早期睾丸扭转,行手法复位,预后良好;中期患者18例,采用手术复位,复位成功14例,失败4例,后期行手术切除4例;晚期患者6例,手术切除患侧睾丸6例。术后随访6个月～1年,保留睾丸的18例中,有3例出现患侧睾丸萎缩;10例行睾丸切除者身体状况良好。结论超声能有效诊断睾丸扭转,并能有效评估睾丸复位成功率。睾丸扭转患者及早治疗,疗效越好,可以提高扭转睾丸的存活率。

Objective To analyze the early diagnosis and treatment of testicular torsion and to improve the survival rate of testicular torsion. Methods 28 patients with testicular torsion from February 2011 to April 2017 in our hospital were enrolled. Color Doppler uhrasonography was performed before admission. The testicular parenchymal echo and blood flow were observed, and the clinical treatment of patients with torsion was reviewed and analyzed. Results Of the 28 patients with testicular torsion, 16 were on the left and 12 on the right. Ultrasound showed that there were 15 cases without testicular blood flow signal completely, 12 patients with significantly reduced testicular blood flow, and 1 with- out change in testieular blood flow. 4 cases of early testieular torsion underwent manual reposition and had good prog- nosis.18 cases of intermediate testieular torsion underwent surgical reposition. Among them, 14 cases were successful and 4 cases were fail. 4 cases were treated with surgical resection in the late stage. 6 cases of testieular torsion under- went surgically removal of ipsilateral testis. After 6 months to 1 year of follow-up, 3 of the 18 patients who retained the testis showed atrophy of the testis, and 10 cases of testieular resection were in good condition. Conclusion Ultrasound can effectively diagnose testieular torsion and can effectively evaluate the success rate of testieular reposition. Early treatment of patients with testieular torsion has better effect, which can improve the survival rate of reverse testis.