儿童嵌顿性腹股沟斜疝致睾丸缺血损伤的影响因素

目的:本研究旨在总结儿童嵌顿性腹股沟斜疝对睾丸缺血损伤的影响因素，以便术前更准确地评估睾丸缺血损伤，从而及时进行睾丸探查或防止不必要的探查。方法:回顾性分析重庆医科大学附属儿童医院2013年7月到2019年6月行疝囊及同侧睾丸探查术的单侧嵌顿性腹股沟斜疝患儿临床资料，收集数据包括年龄、嵌顿时间、肠管损伤程度（术中发现）...

Predictors of testicular injury secondary to incarcerated inguinal Hernia in children

Objective To find out predictors of the testicular ischemia caused by incarcerated inguinal hernia and evaluate the ischemic injury of the testis more accurately,which can indicate testicle exploration in time or prevent unnecessary testicle exploration.Methods Pediatric patients(median:9 months)undergoing operation of unilateral incarcerated inguinal hernia and ipsilateral testicular exploration from 1 Jul.2013 to 30 Jun.2019 were retrospectively investigated.Age at surgery,incarcerate duration,degree of intestinal and testicular injury,times of manual reduction and preoperative ultrasound data were collected.Statistical analysis was performed by SAS 9.4(Copyright?2016 SAS Institute Inc.Cary,NC,USA).Results 460 patients(median:9 months),of which 57(12.39%)(median:1.4 months,interquartile range 0.8-10.7 months)had severe testicular injury,and their average incarceration time was(23.9±9.3)h.Univariate logistic regression revealed that increased times of manual reduction,ultrasound scores,incarcerate duration and degree of intestinal injury were positively correlated with the degree of testicular ischemia,while age at surgery was negatively correlated with the degree of testicular ischemia(Pv0.05).A model for calculating the probability of severe testicular ischemia injury was established:P=1+e^(4.966+1.168Age-1.194 Score-0.845 Time/1)through multivariate analysis with backward stepwise logistic regression and 10-fold cross-validation was used for preliminary verification of the model.Conclusion This study provides a relative reliable model to predict the risk of irreversible testicular ischemia due to incarcerated inguinal hernia using readily available clinical characteristics in young pediatrics with testicular ischemia.