睾丸扭转时间与手术预后分析.docVIP

睾丸扭转时间与手术预后分析 　　【摘 要】目的：探讨睾丸扭转的发病时间与手术预后的关系。方法：本组选择我科1998年―2010年收治的80例睾丸扭转患者，对其发病至手术的时间与采取的手术方式及手术后两年预后的关系进行分析。结果：发病后12小时内手术的32例扭转复位固定患者，术后睾丸均成活，术后两年2例睾丸轻度缩小。发病后12-24小时内手术的28例患者，20例行扭转复位固定术，术后两年3例睾丸有轻―中度萎缩，8例行睾丸切除术。发病24小时后手术的20例患者，18例行睾丸切除术，2例行扭转复位固定术，其中1例术后2周出现睾丸坏死二期手术切除，1例术后两年重度萎缩。结论：12小时以内的扭转术后预后良好，均应行睾丸扭转复位固定术。12-24小时的扭转睾丸成活机率仍然较大，两种手术均有可能。24小时以上者，睾丸成活机率小，且成活睾丸术后萎缩发生率高，总体预后不良，建议行手术切除术。 　　【关键词】睾丸扭转；发病时间；手术方式；预后 　　【中图分类号】R456.12 【文献标识码】B 【文章编号】1004-7484（2014）07-4063-01 　　【Abstract】Objective：To study the relationship of the testicular torsion’s time with operative prognosis. Methods：From 1998 to 2010 ， 80 patients with testicular torsion were retrospectively analyzed on the onset time，the operative method，operative prognosis within two years. Result：32 cases who received surgical detorsion and orchidopexy within 12 hours from attack time had testicles survival，2 case’s testicules appeared mild reduction within 2 years of postoperation.Of 28 cases who had operation within 12 hours to 24 hours from attack time 20 cases who received surgical detorsion and orchidopexy had testicles survival， 3 case’s testicules appeared mild to moderate reduction within 2 years of postoperation，8 cases received orchiectomy.Of 20 cases who had operation more than 24 hours from attack time 18 received orchiectomy， 2 received surgical detorsion and orchidopexy，1 received orchiectomy after 2 weeks of postoperation because of testicular necrosis，1 case’s testicule appeared severe reduction within 2 years of postoperation. Conclusions：the cases should receive surgical detorsion and orchidopexy within 12 hours from attack time because of good prognosis. The cases within 12 hours to 24 hours from attack time can receive surgical detorsion and orchidopexy or orchiectomy because testicles survival rate is high. The cases more than 24 hours from attack time should receive orchiectomy. 　　【Key words】testicular torsion； attack time； operation method； prognosis 　　睾丸扭转又称精索扭转，是由于精索顺其纵轴旋转导致睾丸的