儿童睾丸扭转103例诊治分析

目的提高儿童睾丸扭转的诊治水平。方法回顾分析1993年1月-2008年1月总计103例14岁以下睾丸扭转患儿的诊治临床资料。砖果年龄1．5d～14岁（平均4．8岁）。睾丸扭转部位：左侧64例，右侧34例，双侧5例。9例（8．74％）患儿（扭转〈6h）行手法复位成功；手术探查94例（91．26％），保留睾丸行睾丸固定术25例（21例扭转〈6h，3例扭转12～24h，1例扭转〉24h）。睾丸坏死切除69例。右侧睾丸扭转而左侧精索明显长者19例行对侧睾丸固定术。52例（50．49％）患儿病理报告为睾丸附睾缺血性坏死。38例（36．89％）患儿随访1～6年，未发现再发睾丸扭转，5例患侧睾丸萎缩。结论儿童睾丸扭转的早诊断、及时手术治疗是睾丸成活的关键。

Diagnosis and treatment for children testicular torsion of 103 cases: a retrospective analysis

Objective To improve the diagnosis and treatment of children testicular torsion. Methods 103 clinical cases of child testicular torsion （414 year old） from Jan. 1993 to Jan. 2008 were reviewed and analysed. Results The patients＇ age ranged from 1.5 days to 14 years （mean 4.8 years）. 64 left, 34 right and 5 bilateral testes were involved. Hand replacement succeeded in 9 cases （8.74%） （disease time〈6 h）, surgical examination was carried out in 94 cases （91.26%）, resection of the necrotic testis were performed in 69 cases, orchidopexy were performed in 25 cases （disease time~6 h in 21 cases, 12--24 h in 3 cases, 〉24 h in 1 case）. Orchidopexy was performed in 19 cases of right testicular torsion whose left spermatic cords were obvious long. The pathological reports confirmed ischemic necrosis of testis and epididymis in 52 cases （50.49%）. 38 cases （36.89%） were followed up for 1-6 years with no recurrences, but atrophy of testis were found in 5 cases. Conclusion The key to improve the diagnosis and treatment of child testicular torsion is the combination of case history, physical signs and color doppler ultrasonography. Prompt surgical exploration of the scrotum in order to maintain testicular viability is the best option for testicular torsion.