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睾丸扭转误诊113例分析

The Misdiagnosis of Testicular Torsion (a Report of 113 Cases)

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【作者】 王定勇邓金华宋大清朱茂川余新华郭林森王彦铭

【Author】 Wang Dingyong, Deng Jinhua, Song Daqing, Zhu Maochuan, Yu Xinhua, Guo Linsen , Wang Yanming(Department of Urology, the People’s Hospital of Mianyang, Mianyang, Sichuan 621000, China(Wang DY, Song DQ, Zhu MC, Yu XH, Guo LS, Wang YM); Department of Nephrology,Central Medical Hospital of Mianyang, Mianyang, Sichuan 621000, China(Deng JH)

【机构】 绵阳市人民医院泌尿外科绵阳市中心医院肾内科绵阳市人民医院泌尿外科 四川绵阳621000四川绵阳621000四川绵阳621000

【摘要】 目的 :提高睾丸扭转 (精索扭转 )诊治水平。 方法 :回顾分析 1994~ 2 0 0 4年总计 113例睾丸扭转误诊的临床资料。 结果 :首诊误诊率 84 .3%。误诊为急性附睾、睾丸炎 81例 (71.7% ) ;鞘膜积液 10例 (8.8% ) ;急性肠炎 7例 (6 .2 % ) ;泌尿系结石 5例 (4.4 % ) ;腹股沟疝 5例 (4.4 % ) ;睾丸肿瘤 3例 (2 .7% ) ;附睾结核 2例 (1.8% )。发病至误诊时间 2h~ 2个月 ,平均 6 .3d。手法复位成功 3例 ;92例行手术探查 ,睾丸、附睾切除 6 4例 ,睾丸萎缩 2 6例 ,总计睾丸毁损率 79.6 %。 结论 :提高首诊医生对睾丸扭转的诊治水平是减少误诊的关键 ,诊断流程采用病史、体征、彩超 3者结合 ,治疗的最佳方法是积极开展阴囊急诊的手术探查。

【Abstract】 Objective: To improve the diagnosis and treatment of testicular torsion(or spermatic cord torsion), and reduce its misdiagnosis and mistreatment. Methods: One hundred and thirteen misdiagnosed clinical cases of testicular torsion from 1994 to 2004 were reviewed and analysed. Results: The error rate of initial diagnosis was 84.3%,among which 81 cases( 71.7%) were misdiagnosed as acute epididymitis or testimis, 10( 8.8%) as hydrocele of the tunica vaginalis, and 7( 6.2%) as acute enteritis. The lengths of time between the oncome and diagnosis of the disease varied from 2 hours to 2 months, averaging 6.3 days. Hand replacement succeeded in 3 cases, surgical examination was carried out in 92, resection of the testis or epididymis was performed in 64, testis atrophy occurred in 26, and the total testis impairment rate was 79.6%. Conclusion: The key to the reduction of misdiagnosis is to improve the diagnostic methods, which can be achieved by the combined use of case history, physical signs and color ultrasonography. Surgical examination of the scrotum is the best option for both the diagnosis and the treatment of testicular torsion.

  • 【文献出处】 中华男科学杂志 ,Nationlal Journal of Andrology , 编辑部邮箱 ,2004年11期
  • 【分类号】R697.2
  • 【被引频次】40
  • 【下载频次】242
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