摘要
目的探讨儿童长时间睾丸扭转得以保留原因及对侧睾丸处理方式的选择。方法回顾性分析2016年8月至2019年8月郑州大学第一附属医院收治的阴囊急症患儿,将所有睾丸扭转患儿纳入到研究序列内,概括得以挽救睾丸的临床特点,在探查健侧睾丸时,根据解剖情况采取不同的处理方案。结果80例睾丸扭转患儿纳入研究范围,发病时间为2 h^15 d,均以发现单侧阴囊或腹股沟疼痛来院就诊,74例单侧睾丸扭转,6例隐睾睾丸扭转,均采用手术治疗,69例睾丸坏死行切除术,睾丸得以挽救11例,其中4例睾丸扭转时间较长,其鞘膜内精索较长为主要保留原因。80例健侧睾丸中63例睾丸与鞘膜囊附着正常,17例睾丸与鞘膜囊附着异常。20例患儿(包括5例解剖异常患儿)常规行睾丸鞘膜囊部分切除固定睾丸固定术,12例附着异常者行鞘膜部分切除睾丸固定术,另外48例解剖正常者,探查睾丸后关闭原切口。80例患儿随访过程中,其中保留睾丸的11例睾丸扭转患儿5例恢复正常,6例出现不同程度萎缩,健侧睾丸均未出现扭转、疼痛等不适。结论长时间睾丸扭转得以保留患儿鞘膜囊内精索较长,为其获救赢得时间。健侧睾丸与鞘膜囊附着正常者不需行睾丸固定术,对于并钟摆型异常者,需行鞘膜部分切除睾丸固定术。
Objective To explore the reasons for the retention of long time testicular torsion and the surgical selections of contralateral testis in children.Methods The data of children with acute scrotal emergencies treated by the First Affiliated Hospital of Zhengzhou University from August 2016 to August 2019 were retrospectively analyzed.All the testicular torsion was included in the study sequence to summarize the clinical characteristics of the testicle that could be saved and different treatment methods adopted in the contrary side according to the anatomy of testes.Results A total of 80 children with testicular torsion were included in the study.The onset time ranged from 2 hours to 15 days.All patients came to the hospital with unilateral scrotal pain or inguinal pain,including 74 cases of unilateral testicular torsion and 6 cases of cryptorchidical testicular torsion.All the children were treated with surgery.Orchiectomy was performed in 69 cases of testicular necrosis,and 11 cases were saved,among which 4 cases took a long time for testicular torsion,the main reason for the retention was the longer spermatic cord in the tunica vaginalis.Of the 80 healthy testes,the adhesion of the testis to tunica vaginalis was normal in 63 cases and abnormal in 17 cases.There were 20 children(including 5 children with abnormal anatomy)were routinely treated with partial removal of the tunica vaginalis and orchiopexy.Among the remaining 60 cases,12 cases with abnormal adhesion of the testis to tunica vaginalis underwent partial removal of the tunica vaginalis and orchiopexy,and the other 48 cases with normal anatomy received the testis examination and the original incision closure.During the follow-up of 80 cases,5 cases of the 11 children with the testis preserved returned to normal,6 cases of them showed atrophy to varying degrees,and no discomfort such as torsion or pain was found in all the healthy testes.Conclusions The long spermatic cord in the tunica vaginalis is the reason for long time testicular torsion in children wi
作者
李骥
张谦
郭立华
王磊
刘艳飞
刘宁
王冰蕊
Li Ji;Zhang Qian;Guo Lihua;Wang Lei;Liu Yanfei;Liu Ning;Wang Bingrui(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2020年第21期1659-1662,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
儿童
睾丸扭转
睾丸固定术
睾丸探查术
Child
Testicular torsion
Orchiopexy
Testicular exploration
