彩色多普勒血流显像在睾丸扭转诊治中的价值

目的 探讨应用彩色多普勒血流显像（CDFI）在睾丸扭转诊治中的价值.方法 分析经手术证实的42例睾丸扭转患者的二维及彩色多普勒超声表现.结果 超声检出的42例患者全部经手术证实,诊断符合率为100%（42/42）;睾丸内血流减少伴睾丸动脉阻力指数（RI）增高6例（均值0.91）,均经手法复位存活,存活率达100%,提示此特征为手法复位的可靠指标;8例手法复位患者中,6例CDFI示睾丸内血流减少,2例血流消失,表明手法复位应不仅仅限于血流减少伴RI增高这一条件;24h内就诊复位存活率达70%,24 h后就诊者复位存活率仅21.43%;复位存活患者术后CDFI复查显示睾丸内血流恢复正常.结论 CDFI能较准确地判断睾丸扭转的程度及病情的发展阶段,对早期诊断、手术方式的选择和术后疗效的评价均有较大的指导价值,应作为睾丸扭转的首选辅助检查.

Value of color Doppler flow imaging in the diagnosis and treatment of testicular torsion

Objective To explore the value of color Doppler flow imaging （CDFI） in the diagnosis and treatment of testieulax torsion. Methods Manifestations of color Doppler ultrasonography in the 42 patients with testieular torsion confirmed by surgery were analyzed. Results Forty-two patients with testieulax torsion detected by ultrasound were all confirmed by surgery, the diagnostic accordance was 100% （42/42）. Tests with decreased testlcular blood flow and incresed testicular artery blood flow resistance index（RI） in 6 patients （ mean 0. 91 ） were alive after manual reduction, with 100% survival rate, suggesting that this characteristics was a reliable indicating of closed reduction. In 8 patients with closed reduction, CDFI showed decreased blood flow in 6 patients and disappeared blood flow in 2 patients, indicating that dosed reduction should not just be limited to decreased blood flow with increased RI in this condition. In patients of visiting hospital within 24 h the reduction survival rate was 70% ; in patients of visiting hospital after 24 h the reduction survival rate was only 21.43%. In patients with survived testis CDFI review showed survived testieulax blood flow returned to normal. Conclusion Color Doppler ultrasound can accurately determine the degree of torsion and the seventy of developmental stage, it has greater guidance significance in diagnosis, choice of surgical approach and postoperative evaluation of therapeutic value and should be regarded as the first choice for testieular torsion examinations.