新生儿睾丸扭转的临床分析
The clinical analysis of neonatal testicular torsion
目的 探讨新生儿睾丸扭转的临床特点及治疗时机.方法 回顾性分析2013年1月至2015年12月我们收治的7例新生儿睾丸扭转的临床资料.新生儿日龄1 ~21 d,中位日龄3d;睾丸扭转发病时间1~21 d,中位时间1d.新生儿出生时体重3235~4 125 g,平均3 593.6 g.右侧睾丸扭转4例,左侧2例,双侧1例.临床表现为阴囊肿大2例、阴囊红肿2例,阴囊无痛性肿块2例,阴囊色泽改变1例(双侧).超声检查可见患侧睾丸增大、回声不均或增强、血流信号减少或消失.结果 7例术中均证实为睾丸扭转,鞘膜外型5例(双侧1例),鞘膜内型2例;睾丸扭转角度270°~720°,平均438.8°;睾丸切除率87.5%(7/8).术后随访3~36个月,中位时间12个月.无睾丸扭转再发病例.术后阴囊B超检查睾丸无异常表现.结论 新生儿睾丸扭转临床表现无特异性,当阴囊出现色泽改变、睾丸增大等情况时,即应考虑睾丸扭转可能,应及早手术治疗,减少术中失睾率.
更多Objective To investigate the clinical characteristics and choices of management of neonatal testicular torsion (NTF).Methods Between January 2013 and December 2015,the clinical data of 7 cases of neonatal testicular torsion who were confirmed by surgery and pathological examination in the department of pediatric surgery of our hospital was retrospectively reviewed.Of the 7 NTTs (4 in right,2 in left and 1 in both sides),the median age and onset time of NNTs was 3 d (1-21 d) and 1 d (1-21 d),respectively.The presentation of NTTs included swelling of scrotum,scrotal mass and discoloration of scrotum.Features of ultrasonography included enlargement of testicular volume,echo heterogenicity or enhancement of testis,and decreased or disappeared testicular blood flow.Results All NTTs were performed by surgery and confirmed by pathological examination.In the operation,5 patients with extravaginal torsion (1 bilateral) and 2 with intravaginal torsion were detected.The degree of twisted testis was from 270° to 720°(average 438.8°) and resection rate for necrosis testis was 87.5% (7/8).The median time of follow-up was 12 months (3-36 months),and none of testis underwent re-torsion and the findings of testicular ultrasonography was not abnormal.Conclusions The presentation of neonatal testicular torsion is non-specific.Once the scrotum shows discoloration,swelling,or enlargement of testis,testicular torsion is suspected.Urgent surgical exploration is recommended in order to make an effort to save the testis.
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