精索扭转误诊34例分析

目的 提高精索扭转的诊治水平。方法 回顾分析了1991-2004年34例精索扭转误诊的临床资料。结果 34例全部为院外误诊，误诊急性附睾、睾丸炎28例（82．4％）；鞘膜积液3例（8．8％）；睾丸肿瘤1例（2．94％）；泌尿系结石1例（2．94％）。发病至误诊时间2h-1个月，平均3．5天，来院就诊时间2．5h～1．5个月。平均5．2天，手法复位成功一例，手术复位5例，睾丸附睾切除28例，睾丸毁损率82．35％。结论 提高首诊医生对精索扭转的认识和诊治水平是减少误诊的关键。详细的病史、细致的体检、彩超的应用是诊断关键。最佳治疗是及早积极手术探查。

Misdiagnosis of testicular torsion (Report of 34 cases)

Objective: To improve the diagnosis and treatment of testicular torsion,and to analyze the reason of its misdiagnosis.Methods: To analyze retrospectively the misdiagnosed clinical data of 34 cases of testicular torsion from 1991 to 2004.Results: The error rate of initial diagnosis was 75.6%.Thirty-four cases were misdiagnosed as acute epididymis-orchitis(82.4%),hydrocele of the tunica vaginalis(8.8%),lithangiuria(2.94%)and testicular tumor(2.94%).The length of time from the oncoming to the misdiagnosis of the disease varied from 2.5 hours to 1.5 months,averaging 3.5 days.Hand replacement succeeded in 1 case,surgical examination was carried out in 33 cases,resection of the testis and epididymis was performed in 28 cases.Conclusions: The key to the reduction of misdiagnosis is to improve the diagnostic methods,with color Doppler ultrasonography images(CDFI),testicular torsion has more chances to be diagnosed correctly on time,and the urgent detorsion has to be performed as early as possible.