阴囊急症93例诊断分析

目的 总结阴囊急症患者的临床特点及超声图像特征,提高早期诊断及鉴别诊断的准确率.方法 首先观察93例阴囊急症患者的临床表现及体征;其中78例患者先用二维超声检测睾丸、附睾的位置、大小、形态及回声强弱,再用彩色多普勒观察睾丸、附睾的血供情况,并与临床、手术及病理结果进行对照.结果 93例阴囊急症患者具有相似的临床表现和体征.78例患者经二维超声与彩色多普勒超声检查,28例病侧睾丸血流消失或减少,睾丸内血流阻力指数增高,超声诊断睾丸扭转,与手术病理结果相符.结论 阴囊急症患者的临床表现多样性,易误诊.二维超声结合彩色多普勒超声在阴囊急症患者的诊断中具有较强的敏感性和特异性,是目前鉴别睾丸扭转与急性睾丸附睾炎的首选方法.

Clinical diagnosis of acute scrotal diseases: analysis of 93 cases

Objective To analyze the clinical data and the ultrasonographic characteristics of patients diagnosed as acute scrotal diseases, and to improve the accuracy of early dignosis and differentiation. Methods 78 cases were examined by twodimentioal ultrasound to display the position, size, form, echo of the testis and epididymis, and then the blood perfusion was observed by color Doppler ultrasound. The results were compared with the clinical, operation and pathology. Results The clinical manifestation of 93 cases was similar. 78 cases were examined by two-dimentioal urtrasound and color Doppler ultrasound, 28 cases with disapeared or reduced testicular blood flow and increased resistence indexes diagnosed as torsion of testis were in accord with operative and pathologic results. Conclusion The diversity and non-specifice clinical manifestation of acute scrotal diseases may caused delayed diagnosis. Two-dimentioal ultrasound and color Doppler ultrasound were more sensitive and peculiar in the diagnosis of acute scrotal diseases, and can be regarded as the first choice to distiguish torsion of testis from acute epididymo-testitis.