睾丸扭转诊疗的关键影响因素分析

Analysis on key influencing factors of testicular torsion

目的总结分析各种临床表现的睾丸扭转患者的诊疗结局,分析挽救睾丸的关键因素及误诊原因。方法回顾性分析42例睾丸扭转患者的临床资料,所有患者均完善超声检查并行手术探查,根据治疗结局分为睾丸切除组和睾丸保留组2组,从临床症状、就诊时间、超声结果、扭转度数、扭转类型、家长对疾病的认知等方面进行统计分析。结果2组患者在发病年龄、临床症状、超声诊断、扭转度数、扭转类型等方面比较差异无统计学意义(P>0.05)。保留睾丸组就诊时间为(5.93±2.43)h,切除睾丸组就诊时间为(14.00±5.03)h,2组患者比较差异有统计学意义(P<0.05),保留睾丸组的家长认知明显高于睾丸切除组(P<0.05)。结论手术探查、恢复睾丸血运是挽救扭转睾丸的主要措施。影响睾丸扭转治疗的关键因素是就诊时间。其中,患者家长的职业状况和对疾病的认知是造成误诊的主要原因,家长良好的认知可促使患者及时就医,减少误诊发生。

Objective To summarize and analyze the diagnosis and treatment outcomes of patients with testicular torsion with various clinical manifestations,and to analyze the key factors of testicular rescue and the causes of misdiagnosis.Methods The clinical data of 42 patients with testicular torsion admitted were retrospectively analyzed.All patients were treated with ultrasound examination and surgical exploration,and the patients were divided into two groups according to treatment outcome:testicular resection group and testicular retention group.Clinical symptoms,the time from onset to operation,ultrasound results,torsion degree,torsion type,parents′occupation and parents′cognition of the disease were analyzed.Results There were no significant differences in age of onset,clinical symptoms,ultrasound diagnosis,torsion degree and torsion type between the two groups(P>0.05).The time from onset to operation in the retention group(5.93±2.43)h was significantly shorter than that in the excision group(14.00±5.03)h(P<0.05).The parents in the retention group had significantly higher awareness of testicular torsion disease than those in the excision group(P<0.05).Conclusion The time of consultation is the key factor in saving the torsion testis,the type of occupation of the parents and the lack of knowledge about the disease of testicular torsion is one of the main reasons for misdiagnosis,good knowledge of the parents can motivate the child to seek medical attention in time to minimize the incidence of misdiagnosis.