外伤性睾丸扭转的诊断与治疗.pdfVIP

· 2061· · 诊治要点 · 外伤性睾丸扭转的诊断与治疗 闫道先，刘彦峰，蔡百和 【摘要】 目的 探讨外伤性睾丸扭转的早期诊断与治疗方法，以提高诊治水平。方法 回顾性分析7例外伤性 睾丸扭转患者的临床资料。结果 7例首诊时间均在伤后6 h内，1例依据临床表现确诊，1例经彩色多普勒血流显像 (CDFI)检查确诊，另5例首诊误诊，复诊时经CDFI检查确诊。首诊确诊的2例均手术复位成功，后确诊的5例中1 例手术复位成功，4例睾丸坏死切除，其中1例行对侧睾丸探查固定。结论 外伤性睾丸扭转首诊非常重要，临床尤 其急诊科医生提高对本病的认识能减少误诊，对阴囊闭合性损伤应常规行CDFI检查。首诊确诊和积极手术探查是提高 惠睾挽救率的关键。对侧睾丸不必常规探查。 【关键词】 睾丸疾病；阴囊；超声检查，多普勒，彩色 【中图分类号】R 697．22 【文献标识码】B 【文章编号】1007—9572(2007)24—2061—02 Managementof Traumatic Testicular Torsion YAN Dao—xian，LIU Yah一，eng，CAI Bai—he．Department ofUrology，the Third Municipal Hospital of Luohe，Luohe 462000，China 【Abstract】 0bjective To present our experience in the management of traumatic testicular torsion．Methods Clini— cal data of 7 cases with traumatic testicular torsion were reviewed retrospectively．Results All the 7 cases were given medical aids within 6 hours after trauma．One case was comfirmedly diagnosed on the base of clinical manifestation；one by color doplor flow imaging(CDFI)；The other 5 were misdiagnosed at the first medical examination and later corrected by CDFI．Surgery was performed on 2 confirmedly—diagnosed patients within 6 hours and it proved a success．Among the 5 later—confirm ed patients， one survived the surgery and the other 4 lost their testes due to necrosis．Conclusion Early confirmed diagnosis is important for preservation of involved testes，and CDFI is useful in confirm ing diagnosis． 【Key word】 Testicular diseases；Scrotum；Utrasonography，doppler，color 2例、睾丸挫伤2例、会阴部挫伤1例。误诊者于伤后12 h内 确诊1例，12～24 h内确诊2例，24 h～4 d内确诊2例。伤 后均有剧烈疼痛史，伴晕厥2例，伴恶心、呕吐2例，疼痛向 腹股沟或下腹部放射4例，低热2例。阴囊均有不同程度青紫