儿童睾丸与附睾急症的早期手术干预(附48例报告)

The experience in diagnosis and therapy of Children's emergency of testis and epididymis

目的 :探讨儿童睾丸、附睾急症的早期诊断和治疗原则。方法 :对 4 8例患儿资料进行总结分析。 2 2例行彩色多普勒超声辅助诊断。 4 1例急行探查手术 ,采用回复睾丸扭转并固定、切除坏死睾丸或睾丸附件、释放鞘膜炎性渗液、开放鞘膜减压等方法 ,另 7例行抗感染保守治疗。结果 :4 8例中 ,经探查诊断睾丸附件扭转 2 7例 ,占 5 6 .3% ;精索扭转 7例 ,占 14 .6 % ;除 7例睾丸坏死切除外 ,其余患儿均获治愈。结论 :儿童睾丸、附睾急症在临床表现上缺乏诊断特异性 ,而性腺对缺血缺氧耐受差 ,在无法肯定排除性腺扭转时 ,应尽早进行外科干预 ,手术探查不仅可明确诊断 ,而且可对因施治 ,缩短病程 ,利于睾丸、附睾功能恢复。

Objective:Forty eight emergency cases of testis and epididymis in children were studied to probe into the early diagnosis and management.Methods:Color Doppler ultrasound was applied to 22 patients. Forty one patients were treated with surgical exporation. Seven patients were treated with conservative managment with antibiotic.Results:By exploration, diagnosis was torsion of appendix testis(27 cases, 56.2%), torsion of spermatic cord(7cases,14%),and so on. Seven patients were required orchiectomy because of necrosis of testis, others were cured.Conclusions:Sometimes the children'gonad emergency is nonspecifical in clinic diagnosis. In order to prevent the irreversible damage of testis, early surgical exploration is important