小儿睾丸扭转的超声诊断及临床影响因素分析

Ultrasonic diagnosis and clinical influencing factors of testicular torsion in children

目的分析小儿睾丸扭转的超声表现,探讨相关临床影响因素。方法回顾性分析2015年7月至2019年10月武汉市第一医院收治的98例急性阴囊疼痛患儿的临床资料。根据病理结果分为睾丸扭转52例(观察组),非扭转46例(对照组),所有患儿均接受彩色多普勒超声检查。采用单因素分析和多元Logistic回归分析小儿睾丸扭转与年龄、疼痛持续时间、血流信号、回声信号、提睾肌反射和睾丸位置抬高等因素的相关性。结果98例急性阴囊疼痛患儿中,超声诊断小儿睾丸扭转61例,临床病理诊断小儿睾丸扭转52例,诊断灵敏度为96.15%(50/52),特异度为76.09%(35/46),准确度为86.73%(85/98)。单因素分析结果显示,两组疼痛持续时间、回声强度、血流信号比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,疼痛持续时间是小儿睾丸扭转发生的独立危险因素。结论小儿睾丸扭转发生率较高,疼痛持续时间对小儿睾丸扭转的诊断具有预测意义。

Objective To analyze the ultrasonic manifestations of testicular torsion in children and explore the related clinical influencing factors.Methods The clinical and pathological data of 98 children with acute scrotum in Wuhan NO.1 Hospital from July 2015 to October 2019 were retrospectively analyzed,including 52 cases of testicular torsion(the observation group),46 cases of non-testicular torsion(the control group).All patients underwent color Doppler ultrasonography.Univariate analysis and multivariate Logistic regression analysis were used to investigate the correlations between the occurance of testicular torsion in children and the related factors,including age,duration of onset,blood flow signal,echo signal,diameter ratio,cremaster reflex and testicular position.Results Among 98 cases of acute scrotal pain,61 cases of testicular torsion were diagnosed by ultrasound,52 cases were diagnosed by clinicopathology,the diagnostic sensitivity was 96.15%(50/52),the specificity was 76.09%(35/46),and the accuracy was 86.73%(85/98).Univariate analysis showed that there were statistically significant differences in duration of onset,echo intensity and blood flow signal between the two groups(P<0.05).Multivariate Logistic regression analysis showed that duration of onset was an independent risk factor for testicular torsion in children.Conclusions There is a high occurrence of testicular torsion in children.The duration of onset has important predictive significance for the diagnosis of testicular torsion in children.