血液学检测在小儿睾丸扭转诊疗中的预测价值

The predictive Value of hematologic Examination in Diagnosis and Treatment of testicular Torsion in Children

目的探讨血液学检测在小儿睾丸扭转和急性附睾睾丸炎鉴别诊断中的应用,并探讨血液学参数在小儿睾丸扭转诊断中的预测价值。方法本研究回顾性分析了本院2016年1月—2018年12月因阴囊疼痛住院的患儿病例资料。将病例资料分成3组,即睾丸扭转组、急性附睾睾丸炎组和对照组。其中睾丸扭转组11例,均接受手术治疗(切除睾丸或睾丸固定),急性附睾睾丸炎组25例,对照组30例健康儿童。分析比较各组患儿年龄、术前血液检测参数[包括中性粒细胞与淋巴细胞比率(NLR)、单核细胞与嗜酸性粒细胞比率(MER)、血小板与淋巴细胞比率(PLR)等]的差异性。结果睾丸扭转组与急性附睾睾丸炎组比较中性粒细胞计数、淋巴细胞计数、嗜酸性细胞计数、NLR、MER、PLR差异具有统计学意义(P<0.05),有助于临床鉴别诊断;对照组中的中性粒细胞计数、血小板计数、白细胞计数、NLR、MER和CRP值均低于扭转组,差异具有统计学意义(P<0.05)。MER在预测小儿睾丸扭转的敏感性(63.6%)和特异性上(96.7%)与多普勒超声的敏感性(63%~86%)和特异性(97%~100%)相当,且通过ROC曲线对比分析,MER的敏感性(63.6%)要优于NLR(54.5%)。结论MER在预测小儿睾丸扭转的敏感性和特异性上与多普勒超声的敏感性和特异性相当,且敏感性更优于NLR,提示MER在小儿睾丸扭转中具有预测价值。

Objective To explore the application of hematologic detection in differential diagnosis of testicular torsion and acute epididymitis in children,and to explore the predictive value of hematological parameters in the diagnosis of testicular torsion in children.Methods The clinical data of hospitalized children with scrotal pain from January 2016 to December 2018 in our hospital were analyzed retrospectively.The patients were divided into 3 groups:testicular torsion group,acute epididymitis group and control group.Among them,11 cases of testis torsion group were treated by operation,25 cases of acute epididymitis group and 30 cases of control group.The differences of age,preoperative blood test parameters(including neutrophil to lymphocyte ratio(NLR),monocyte to eosinophil granulocyte ratio(MER),platelet to lymphocyte ratio(PLR)in each group are analyze and compared.Results There were significant differences in neutrophil count,lymphocyte count,eosinophil count,NLR,MER,PLR between testicular torsion group and acute epididymitis group(P<0.05),It is helpful for clinical differential diagnosis The neutrophil count,platelet count,white blood cell count,NLR,MER and CRP in the control group were significantly lower than those in the torsion group(P<0.05).The sensitivity(63.6%)and specificity(96.7%)of MER were similar to those of doppler ultrasound(63%~86%)and specificity(97%~100%).The sensitivity(63.6%)of MER was better than that of NLR(54.5%).Conclusion MER has the same sensitivity and specificity as doppler ultrasound in predicting testicular torsion in children,and its sensitivity is better than NLR,which suggests that MER has predictive value in testicular torsion in children.