隐睾扭转6例诊治分析

Clinical analysis of 6 cases of cryptorchidism

关键词:  睾丸扭转  隐睾  诊断  手术治疗

Key words:  testiculartorsion  cryptorchidism  diagnosis  surgical treatment

摘要:

目的　探讨隐睾扭转的主要特点及诊治要点。方法　回顾性分析承德医学院附属医院2011年11月至2016年11月收治的6例隐睾扭转患者的临床资料，收集患儿发病年龄、发病至确诊时间、确诊至手术时间、隐睾类型、发病部位、扭转度数、手术方式、Arda分级评分以及误诊情况。结果　早期误诊2例。6例患儿发病至确诊平均时间为39.5 h（7～96 h），确诊至手术平均时间为4.5 h（2～6 h）。左侧隐睾扭转4例，右侧隐睾扭转2例，睾丸平均扭转630°（360°～1080°）。其中2例行睾丸切除术，4例手术复位。结论　对于怀疑隐睾合并睾丸扭转的患儿应尽早行彩色多普勒超声检查和手术探查以明确诊断，尽可能挽救扭转的睾丸。

Abstract:

Objective　To study the clinical characteristics, diagnosis and treatment of torsion of cryptorchidism. Methods　Retrospective analysis was performed on 6 cases of torsion of cryptorchidism from November 2011 to November 2016. The clinical data were collected, including onset age, time period from onset to diagnose, time period from diagnosis to operation, the type, location and reverse degree of cryptorchidism, operation method, grade of Arda score and misdiagnosis. The related literatures were review. Results　There were 2 cases of misdiagnosis in the early stage. The mean time between onset and diagnosis was 39.5 h (7-96 h), and the mean time between diagnosis and operation was 4.5 h (2-6 h). The torsion of cryptorchidism occurred on left side in 4 cases and on right side in 2 cases with an average degree of 630°（360°-1080°）. Treatment included orchiectomy in 2 cases and surgical reduction in 4 cases. Conclusions　For children suspected for cryptorchidism complicated with testicular torsion, color doppler ultrasonography and surgical exploration should be performed as soon as possible to clarify the diagnose and relieve the testicular torsion.