睾丸扭转和精索扭转的诊断与治疗(附68例报告)

目的:探讨睾丸和精索扭转的诊断与治疗方法,提高睾丸和精索扭转的治疗水平。方法:对68例睾丸和精索扭转的临床资料进行总结,68例平均年龄21岁,<20岁者占84%,左侧55例占80.8%.发病至确诊时间6h～30天,12h以上者占90.2%。结果:53例术前彩色多普勒血流动态显象(CDFI)应作为诊断疾病的常见与首选检查方法。诊断并经手术证实,符合率100%,经手术探查;41例行手术复位、固定,睾丸获救。27例行患侧睾丸切除术,所有病例均行对侧探察,固定。结论:阴囊X核素显象,B超对睾丸精索扭转早期诊断有帮助。早期诊断,及时治疗是提高疗效的关键。彩色多普勒血流动态显象应作为诊断该疾病的常见及首选检查方法,对睾丸精索一旦确诊或疑有精索扭转的患者应及早行紧急复位,以期挽救睾丸,同时行睾丸固定术也十分必要。对于确诊毫无保留价值的睾丸需行切除术。

Diagnosis and treatment of testicular torsion and spermatic cord torsion(Report of 68 cases)

Objective:To evaluate the diagnosis and treatment of testicular torsion and spermatic cord torsion, and to improve its diagnosis and treatment.Methods:The clinical data of 68 cases of testicular torsion and spermatic cord torsion were summarizd and analyed.Mean age of the patients was 21 years(crange,20 years),with 84% of which occurring in patients younger than 25 years and being in the left side,the elapse of time from onset to a definite diagnosis was 6 h~30 d,with 90.2%>12 h.Results:Fifty three cases had preoperation Color Doppler Flow Imaging (CDFI) and had been confirmed the diagnosis,which were proved by surgery. Ipsilateral testicles in 41 cases were salvaged by surgical detorsion and orchiopexy and all contralaleral testicles were performed preventive orchiopexy.Conclusions:It is helpful to get diagnosis for early testicular torsion and spermatic cord torsion by radionuclide imaging of serotum and B-ultrasound. And timely treatment are key of improving therapeutic effect. Color Doppler Flow Imaging(CDFI) should be considered the primary diagnostic approach for surotal emergencies.