睾丸扭转的彩色多普勒超声诊断效果及临床疗效

Diagnostic effect and clinical efficacy of color Doppler ultrasonography in testicular torsion

目的分析彩色多普勒超声在睾丸扭转诊断中的应用价值及睾丸扭转的临床疗效。方法 60例经彩色多普勒超声诊断后行手术复位的睾丸扭转患者,以术后病理学诊断结果为标准分析超声诊断的准确率,观察并分析不同发病时间及不同扭转程度分别对术后失睾率的影响。结果 60例患者经术后病理学诊断证实,睾丸扭转患者58例,均为鞘膜内扭转,急性附睾-睾丸炎2例,超声诊断准确率为96.67%。58例睾丸扭转患者中,手术复位36例,手术切除22例,总失睾率为37.93%。发病后<6 h就诊患者失睾率为0,发病后6～24 h就诊患者失睾率为27.59%,发病后>24 h就诊患者失睾率为93.33%,三组比较差异具有统计学意义(P<0.05);睾丸扭转程度<180°的患者失睾率为16.67%,睾丸扭转程度180～360°的患者失睾率为31.03%,睾丸扭转程度>360°的患者失睾率为90.91%,三组比较差异具有统计学意义(P<0.05)。结论对于睾丸扭转的患者,应做到早诊断、早治疗,以避免手术切除情况的发生。彩色多普勒超声对睾丸扭转具有较高的诊断准确率,可作为临床检查的优选方法。

Objective To analyze the application value of color Doppler ultrasonography in testicular torsion and the clinical efficacy of testicular torsion. Methods 60 patients with testicular torsion diagnosed by color Doppler ultrasonography were treated with surgical reduction. The accuracy of ultrasonography diagnosis was analyzed according to the pathological diagnosis after operation. The influence of different length of onset and different degree of torsion on the rate of postoperative testis was observed and analyzed. Results Postoperative pathological diagnosis confirmed that 58 cases of testicular torsion were intrathecal torsion and 2 cases of acute epididymitis-orchitis in 60 patients, with accuracy rate of ultrasonography diagnosis as 96.67%. Among 58 cases of testicular torsion, 36 cases underwent surgical reduction and 22 cases underwent surgical resection, with total rate of testis loss as 37.93%. The rate of testis loss in patients treated <6 h after onset was 0, 27.59% for patients treated in 6~24 h after onset, and 93.33% for patients treated >24 h after onset. Three groups had statistically significant difference(P<0.05). The rate of testis loss in patients with testicular torsion <180° was 16.67%, 31.03%for patients with testicular torsion 180~360°, and 90.91% for patients with testicular torsion >360°. Three groups had statistically significant difference(P<0.05). Conclusion For patients with testicular torsion, early diagnosis and treatment should be made to avoid surgical excision. Color Doppler ultrasound has a high diagnostic accuracy for testicular torsion, and can be used as an optimal method for clinical examination.