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目的总结睾丸扭转患儿的临床表现,以提高睾丸扭转的诊断及治疗水平。方法回顾性分析重庆医科大学附属儿童医院泌尿外科1990年1月至2008年11月收治住院阴囊急症患儿中103例睾丸扭转的临床表现及诊治情况。结果睾丸扭转发病高峰年龄为1岁以内及11～15岁,占85.4%。睾丸肿痛、提睾反射消失为主要临床表现;超声对诊断睾丸扭转有意义,主要表现为睾丸肿大(73.8%)、睾丸质地不均(75.7%)、血流减弱或消失(91.3%)。睾丸毁损与就诊时间及扭转度数呈明显负相关(r值分别为-0.965及-0.953,P值分别为0.008及0.012)。获得随访的86例患儿均有对侧睾丸增大,但性激素水平及青春期第二性征发育不受影响。结论睾丸扭转的早期临床表现易与其他阴囊急症相混淆。超声检查帮助鉴别诊断,早期手术探查可提高扭转睾丸存活率。一侧睾丸缺失不影响其后的性激素水平及青春期第二性征的出现。
Objective To summarize the clinical manifestations of children with testicular torsion in order to improve the diagnosis and treatment of testicular torsion. Methods Retrospective analysis of clinical manifestations and diagnosis and treatment of 103 cases of testicular torsion in children with scrotal emergency admitted to Department of Urology, Children’s Hospital Affiliated to Chongqing Medical University from January 1990 to November 2008. Results The incidence of testicular torsion peak age of 1 year old and 11 to 15 years old, accounting for 85.4%. (73.8%), uneven texture of the testis (75.7%), blood flow weakened or disappeared (91.3%), and the testicular swelling and testicular swelling were the main clinical manifestations. Ultrasound was of significance for the diagnosis of testicular torsion. . Testicular lesions were significantly negatively correlated with the time of treatment and degree of torsion (r = -0.965 and -0.953, P = 0.008 and 0.012, respectively). All of the 86 children who were followed up had contralateral testicular enlargement, but the development of sex hormones and adolescent secondary sexual characteristics were not affected. Conclusion The early clinical manifestations of testicular torsion are easily confused with other scrotal emergency. Ultrasonography to help differential diagnosis, early surgical exploration can improve testicular survival rate. Side of the testicular loss does not affect the subsequent level of sex hormones and adolescent secondary sexual characteristics appear.