论文部分内容阅读
目的 探讨儿童睾丸附件扭转保守治疗的指征。方法 回顾性总结分析 1993～ 1997年底的 2 5例急性阴囊疼痛患儿的诊疗情况 ,结合文献提出鉴别诊断及选择疗法的依据 ,将其应用于1998年以后收治的 2 6例患儿中 ,进一步探讨诊断和治疗指征。结果 回顾性总结表明 :睾丸扭转症状重 ,就诊早 ,就诊时间多在发病 2 4h之内。附件扭转疼痛轻 ,就诊晚 ,多有 48h以上的病史 ,两者比较 ,差异有显著性意义 (P <0 .0 5 )。 1998年后治疗的 2 6例中 ,5例就诊时疼痛时间短于 48h ,1例在睾丸上极摸到疼痛性结节 ,诊断睾丸附件扭转 ,行保守治疗 ;4例行急症手术 ,证实 1例睾丸扭转、3例附件扭转。 2 1例就诊时疼痛已 48h以上 ,19例症状轻 ,彩色多普勒检查 ,睾丸血流正常 ,行保守治疗 ,治疗过程中均可摸到大小不等的触痛性结节 ,诊断睾丸附件扭转。 2例睾丸扭转坏死而行睾丸切除。结论 睾丸附件扭转是一种自限性疾病。扪到其特有体征 ,即阴囊内触疼性结节者 ;阴囊痛持续48h以上 ,彩色多普勒检查 ,睾丸血流正常者 ,可行保守治疗。睾丸扭转是外科急症 ,应急症手术。彩色多普勒超声检查对鉴别诊断有重要意义
Objective To investigate the indications of conservative treatment of children with testicular attachment torsion. Methods The clinical data of 25 children with acute scrotal pain from 1993 to 1997 were retrospectively analyzed. Based on the evidences of differential diagnosis and selection therapy in the literature, they were applied to 26 children who were admitted after 1998 Discuss diagnosis and treatment indications. Results retrospectively concluded that: testicular torsion symptoms, early treatment, treatment time and more in the pathogenesis of 2 4h. Attachment to reverse the pain light, late treatment, more than 48h history, the two compared, the difference was significant (P <0. 05). Among the 26 cases treated after 1998, the pain time of 5 cases was shorter than 48 hours, one case had painful nodules on the testicle, and the testicular appendages were reversed and treated conservatively. Four cases of emergency surgery confirmed 1 Cases of testicular torsion, 3 cases of attachment reversed. 21 cases of pain at the time of treatment has been more than 48h, 19 cases of mild symptoms, color Doppler examination, normal testicular blood flow, conservative treatment, the treatment process can be touched to varying sizes of tender nodules, diagnosis of testicular appendages Twist. 2 cases of testicular torsion necrosis and orchiectomy. Conclusion Testicular attachment torsion is a self-limiting disease. Palpable to its unique signs, that is, touch the nodular scrotum; scrotal pain sustained 48h or more, color Doppler examination, normal testicular blood flow, viable conservative treatment. Testicular torsion is a surgical emergency, emergency surgery. Color Doppler ultrasound is important for differential diagnosis