Diagnosis and treatment of neonatal testicular torsion.. Diagnosis and treatment of neonatal testicular torsion.[J].Journal of Clinical Pediatric Surgery,2018,17(12):943-949.
新生儿睾丸扭转诊治体会并文献复习
- Title:
- Diagnosis and treatment of neonatal testicular torsion.
- Keywords:
- ; Spermatic Cord Torsion; Diagnosis; Surgical Procedures; Operative; Neonate
- 文献标志码:
- A
- 摘要:
- 目的探讨新生儿睾丸扭转(neonatal testicular torsion，NTT)的诊断及治疗方法。 方法对2014年7月至2017年3月由安徽省儿童医院收治的7例新生儿睾丸扭转患儿的临床资料进行综合分析及文献复习。 结果7例新生儿睾丸扭转病例中，顺产6例，剖宫产1例；均为足月儿；年龄1~27 d（平均6.4 d）；左侧4例，右侧3例，临床表现为患侧阴囊不同程度红肿，内可扪及质硬包块，触痛阳性，病程最短6 h，最长10 d；彩超检查均提示患侧阴囊内不均质团块回声，睾丸血流信号消失；7例予手术探查，术中发现患侧睾丸均扭转坏死，予手术切除，术后病理结果均提示睾丸坏死，1例可见钙化灶。 结论新生儿睾丸一旦扭转，坏死的发生率高，当临床上不能排除睾丸扭转时，应尽早手术探查，彩色多普勒血流显像在睾丸扭转的诊断和鉴别诊断中具有较高的准确度和特异性。
- Abstract:
- ObjectiveTo explore the diagnosis and treatment of neonatal testicular torsion (NTT).MethodsRetrospective review was conducted for the clinical data of 7 NTT cases from July 2014 to March 2017.ResultsAmong them,term delivery was natural birth (n=6) and cesarean section (n=1).The average age was 6.4(1-27) days.And the involved side was left (n=4) and right (n=3).There were varying degree of testicular swelling,tenderness and hard masses at the affected side.The time from onset to arrival to hospital ranged from 6h to 10d.In all cases,color and power Doppler revealed heterogeneous masses of scrotum and absent blood flow in testis.Surgical exploration revealed testicular ischemic infarction and postoperative histopathology hinted at necrosis of testicular tissue.All affected testes were removed.ConclusionThere is a high rate of neonatal testicular torsion and necrosis.When a diagnosis of testicular torsion cannot be ruled out by clinical symptoms,surgical exploration should be performed as soon as possible.Color Doppler flow imaging (CDFI) has high accuracy and specificity in the diagnosis and differential diagnosis of testicular torsion.
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