230例隐睾临床分析

Clinical diagnosis and treatment in 230 cases of cryptorchidism

目的 总结隐睾及其并发症的诊治经验 ,提高对隐睾合理治疗年龄的认识。 方法 回顾性分析 1996至 2 0 0 1年 2 30例 2 99侧隐睾患者诊治资料。就诊时年龄 1～ 5 9岁 ,平均 (9.5± 9.0 )岁。左侧 88例 ,右侧 73例 ,双侧 6 9例。合并尿道下裂 11例 ,隐匿性阴茎 2例。 结果 2岁以内手术治疗患者 2 5例 (10 .9% )。手术治疗 2 89侧 ,其中行一期下降固定术 2 73侧 ,另外疑为萎缩或恶变而行手术切除送病理 15侧 ,探查缺如 1侧。手术 2 89侧中 2 73例下降固定术后随访 4个月～ 5年 ,2 70例未见睾丸回缩及萎缩 ,成功率 98.9% (2 70 / 2 73侧 )。腹外型 2 6 0侧 (90 .0 % ) ,腹内型 2 5侧 (8.7% ) ,缺如 4侧 (1.4 % )。合并斜疝 74侧 (2 5 .6 % ) ,鞘状突未闭 2 4侧 (8.3% ) ,睾丸附睾分离 33侧 (11.4 % )。14 6侧腹外型隐睾B超检查符合率 86 .3% (12 6 / 14 6 ) ,查体符合率 6 3.0 % (92 / 14 6 ) ,P <0 .0 0 5。 结论 2岁以内最佳手术时机的隐睾患者诊治率明显偏低 ,应引起重视。B超对隐睾的定位诊断符合率较高。

Objective To evaluate the diagnosis and treatment of cryptorchidism and its complications,and to emphasize the appropriate surgical treatment age of cryptorchidism. Methods The data of diagnosis and treatment of 230 cases of cryptorchidism (a total of 299 undescended testicles) were reviewed.Their ages varied from 1 to 59 years and the mean age was (9.5±9.0)years.88 cases had cryptorchidism on the left side;73 cases on the right side;and 69 cases on both sides.Cryptorchidism was complicated by hypospadias in 11 cases and by latent penis in 2 cases. Results In these series only 25 cases (10.9%) underwent surgical treatment within 2 years of age.Surgical operations were performed in these cases (289 sides) and the locations of the undescended testicles were determined.Of them 273 ones underwent primary descending and fixation,15 ones underwent resection and histopathological examinations for mahgnant or shrinked tendency 1 was absent during the detection,and they were followed up for 4 months to 5 years with the success rate being 98.9 %.Of these cases 260 ones(90.0%) were external abdominal;25 ones (8.7%) were intra-abdominal;4 ones were missing (1.4%).For external abdominal testicles the positive ratio of detections by B-ultrasonography was 86.3%(126/146) and that of physical examination was 63.0% (92/146),which showed statistically significant difference ( P <0.005). Conclusions The best opportunity of surgical treatment for cryptorchidism is within 2 years of age.However,fewer patients visit the doctors at this period of age,therefore more attention should be paid to these case population.B-ultrasonography is useful for the location diagnosis of undescended testicles.