急性附睾睾丸炎致睾丸坏死6例报告并文献复习

目的提高对急性附睾睾丸炎致精索血运障碍的认识。方法对6例急性附睾睾丸炎后睾丸坏死患者的临床资料进行总结。结果5例精索增粗,5例患者术前超声中有4例提示患侧睾丸回声下降,4例精索鞘膜与睾丸鞘膜移行处形成狭窄环,4例附睾中明显有炎性结节形成。6例术后病理均示睾丸坏死。结论急性附睾睾丸炎保守治疗发生睾丸坏死的可能性存在,其原因可能为精索血运障碍。对保守治疗效果不佳的病例应早期手术治疗。

Testicular necrosis due to acute epididymal testitis(a report of 6 cases)

Objective To better understand severe epididymal testitis with funicular blood circulation disorder. Methods The clinical materials and laboratory examination of 6 cases without testis due to severe epididymal testitis were summerized retrospectively. Results Spermatic cords of 5 cases changed to be thicker. The ultrasonography of 5 cases before the operation all showed a decrease of testicular echo pattern on the affected side. Four cases showed a narrow loop at the juncture of spermatic and testicular tunica vaginalis. Four cases had obvious inflammatory nubble of spermatic cord. Six cases all confirmed to have testicular infarction by pathological analysis. Conclusion Testicular necrosis might be developed in patients with acute epididymal testitis who received conservative management because of blood disorder of spermatic cord. A early surgical exploration should be taken for treated patients under inefficacy of conservative therapy.