摘要目的 探讨新生儿睾丸扭转(neonatal testicular torsion,NTT)的临床特点及诊疗措施.方法 选取2008年3月至2018年7月深圳市儿童医院收治的NTT患儿病例资料,对患儿基本情况、睾丸扭转时间、临床表现、超声检查结果、手术方法、病理结果、随访及预后等进行回顾性分析.结果共纳入NTT患儿12例,均手术确诊.起病日龄1～10 d,平均2.9 d,其中6例为生后1 d内起病.起病至就诊中位时间为3.5 d,最短2 h,最长28 d.首发症状为阴囊肿胀/包块,其中左侧7例,右侧5例.9例伴有阴囊颜色改变(发红/青紫).彩超检查均提示睾丸实质血流信号消失或明显减少,超声敏感率100％.入院至手术时间(2.1±1.1)h.12例均经患侧阴囊睾丸探查,确认睾丸坏死后行睾丸切除术.8例同期行对侧睾丸固定术.术后均无伤口出血或感染,平均住院时间6.4 d.病理结果 回报曲细精管仅残存轮廓9例,曲细精管结构消失3例.术后随访3～24个月,未发现对侧睾丸扭转或萎缩.结论 NTT患儿睾丸坏死率高,临床出现阴囊肿胀新生儿应尽早结合彩超检查确诊,必要时及时手术探查.

abstractsObjective To study the clinical features, diagnosis and treatment of torsion of testes in newborn. Method Neonates who were diagnosed with neonatal testicular torsion and admitted to Shenzhen Children's Hospital from March 2008 to July 2018 were studied. The clinical data such as days in age, time of onset, clinical manifestations, time of ultrasound examination, characteristics of ultrasound examination, surgery time, surgical types, postoperative conditions, pathological findings, and follow-up results were retrospectively analyzed. Result A total of 12 infants with torsion of testes were enrolled. The average onset time was 2.9 d, ranged from 1～10 d. The time of onset was within 24 h after birth in six infants. The median duration from onset to seeing a doctor was 3.5 d, ranged from 2 h to 28 d. First manifestations being reported grammer were scrotal swelling or mass, including 7 cases on the left side and 5 cases on the right side. Among them, 9 cases were associated with redness or cyanosis of the scrotum. Ultrasound was characterized by the disappearance or significant reduction of testicular parenchymal blood flow signal, and the sensitivity of ultrasound was 100％. The average time from admission to operation was (2.1±1.1) h. All the 12 infants had orchiectomy,after necrosis of unilateral testicle was confirmed. Eight of them underwent contralateral test icular fixation. The average operation time was 46 min. There was no wound bleeding or infection postoperatively, and the average hospital stay was 6.4 d. The pathological features were blurred residual contour of the seminiferous tubule (9 cases) or the disappearance of the seminiferous tubule structure (3 cases). After 3 to 24 months of follow-up, no contralateral testicular torsion or atrophy was found. Conclusion The rate of testicular necrosis in children with torsion of testes is high. The newborn with scrotal swelling should be diagnosed promptly with color Doppler ultrasound. If necessary, surgical exploration should be performed in time.