儿童睾丸扭转和睾丸附件扭转的临床特征及超声表现

Clinical features and ultrasound findings of testicular torsion and torsion of the appendix testis in children

目的分析儿童睾丸扭转(TT)和睾丸附件扭转(TAT)的临床特征及超声表现。方法选取2020年3月至2021年10月南京医科大学附属淮安第一医院收治的72例TT和TAT患儿,其中TT 37例,TAT 35例。分析年龄、部位、临床症状、体征、疼痛持续时间、白细胞计数、超声检查结果。结果TT患儿年龄大于TAT患儿;TT多发于12~16岁儿童,TAT多发于7~11岁儿童;TT患儿睾丸肿胀、睡眠间发作、高位睾丸、高白细胞计数的占比高于TAT患儿;TT患儿的症状持续时间多<6 h和>48 h,而TAT患儿症状持续时间多在6~48 h;70.27%的TT患儿可见精索扭曲,而TAT未见此征象;彩色多普勒超声显示TT受累睾丸血流信号消失或减少,而TAT血流信号增加或正常,差异均有统计学意义(P<0.05)。结论彩色多普勒超声在TT和TAT中的不同特征性表现是鉴别TT和TAT的重要参考依据,并结合年龄、睡眠间发作、高位睾丸、高白细胞计数、症状持续时间等临床特征,有助于临床鉴别诊断TT和TAT。

Objective To analyze the clinical features and ultrasound findings of testicular torsion(TT)and torsion of the appendix testis(TAT)in children.Methods A total of 72 children with TT and TAT treated in the Affiliated Huai’an NO.1 People’s Hospital of Nanjing Medical University from March 2020 to October 2021 were selected,including 37 children with TT and 35 children with TAT.Age,location,clinical symptoms,signs,pain duration,white blood cell count,and ultrasound results were analyzed.Results The age of TT children was higher than that of TAT children.TT was more common in children aged 12 to 16 years,TAT was more common in children aged 7 to 11 years.The proportion of testicular swelling,sleep seizure,high testicle and high white blood cell count in TT children was higher than that in TAT children.The duration of symptoms in TT children was>6 h and>48 h,while the duration of symptoms in TAT children was 6-48 h.The spermatic cord was distorted in 70.27%of TT children,but not in TAT.Color Doppler ultrasonography showed that the blood flow signal of TT affected testis disappeared or decreased,while the blood flow signal of TAT increased or normal,and the differences were statistically significant(P<0.05).Conclusion The different characteristics of color Doppler ultrasonography in TT and TAT are an important reference for the identification of TT and TAT,and combined with clinical characteristics such as age,intersleep onset,high testicle,high white blood cell count,and symptom duration,it is helpful for the clinical differential diagnosis of TT and TAT.