儿童精索静脉曲张130例临床分析

目的总结儿童精索静脉曲张的临床特点及诊治体会，探讨其所致睾丸差异生长的临床意义。方法回顾性分析作者收治的130例精索静脉曲张患儿临床资料。结果130例中，左侧128例，双侧2例，发病年龄10岁以上者120例。首发症状为阴囊内包块者109例，体检发现者15例，阴囊疼痛、坠胀不适4例，左右阴囊大小不一2例。超声检查提示合并症以睾丸微石症最常见。130例均予手术治疗，其中开放手术13例，腹腔镜手术117例。术后随访105例无复发及睾丸萎缩。92例记录睾丸大小的患儿中，51．1％存在双侧睾丸差异生长，且随着临床分度的递增而睾丸差异生长显著。结论儿童精索静脉曲张以左侧多见，好发于10岁以上儿童，极少有自觉症状，诊断主要依靠体格检查及彩超，治疗上以手术为主，腹腔镜手术有望成为首选。睾丸差异生长是儿童精索静脉曲张较可靠的手术指征，合并睾丸微石症的发生率仍须进一步研究。

The analysis of 130 varicoceles in children

Objective To summarize the clinical presentation and treatment experiences, discuss the prevalence of testicutar size discrepancy in children with vari6oceles. Methods Retrospective analyzed the clinical data of 130 varicoceles who hospitalized. Results Of the 130 varicoceles, left side 128 cases, both sides 2 cases, the age of onset over 10 -year old 120 cases, mass in scrotal was the most common chief complain and the testicular microlithiasis was the most common complication. All were treated by surgeries,117 underwent the laparoscopy surgery. 105 were followed up and none recurred. Testicular volumes of 92 patients were recorded, among which 51.1% testicular size discrepancy was found and the mean volume differential was increased with the clinical grade. Conclusion Varicocele is also popular in children especially over 10-year old, it usually happens on the left side without specific symptoms, physical examination and ultrasound can confirm the diagnosis, laparoscopy surgery could be the first choice. Testicular size discrepancy maybe the best indication of surgery intervention and the high rate of testicular microlithiasis need further research.