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目的通过回顾性临床资料分析,进一步提高急性睾丸扭转的诊疗水平。方法分析16例(其中2例为双侧睾位扭转)睾丸扭转患者经诊治后随访3~15年的临床资料。结果 7例行患侧睾丸复位固定术及对侧睾丸预防性固定术,7例行患侧睾丸切除术及对侧睾丸预防性固定术,1例双侧睾丸扭转行双侧睾丸切除术,1例双侧睾丸扭转行左侧睾丸切除术及右侧睾丸复位固定术。手术切除标本病理检查均为睾丸坏死。16例随访3年~15年,随访期间1例无睾丸患者血清睾酮偏低;其余15例患者未见明显血清睾酮异常。未切除睾丸的15例中有8例8侧(其中7例患侧睾丸行复位固定术,另1例是双侧睾丸扭转,1侧睾丸行复位固定术)患者患侧睾丸复位固定术后未再次发生患侧睾丸扭转,l例术后出现患侧复位固定的睾丸较同龄人轻度缩小;14例14侧(其中7例患者行睾丸切除术,7例患侧行睾丸复位固定术)患者对侧睾丸预防性固定术后未发生预防侧睾丸的扭转,l例术后出现对侧预防性固定的睾丸较同龄人轻度缩小。16例中,除了1例无精子症外,2例为少精子症,l例为弱精子症,l例为少弱精子症,余11例精液检查均正常。1例无睾丸患者为无精子症,未见明显阴茎晨间勃起,为重度阴茎勃起功能障碍,2例患者(其中1例为弱精子症,1例为少弱精子症)出现轻度阴茎勃起功能障碍,13例患者无勃起功能障碍;随访期间11例生育下一代。结论彩色多普勒血流显像是诊断急性睾丸扭转的可靠方法,早期手术探查对提高睾丸成活率及保护其功能有重要意义。
Objective Through retrospective clinical data analysis, to further improve the diagnosis and treatment of acute testicular torsion. Methods Clinical data of 16 cases (2 cases with bilateral testicular torsion) who were followed up for 3 ~ 15 years after the treatment of testicular torsion were analyzed. Results Seven cases of ipsilateral testis fixation and contralateral testicular prophylactomy were performed. Seven cases of ipsilateral orchidectomy and contralateral testicular prophylactic fixation were performed. One case underwent bilateral orchidectomy with testicular torsion. Cases of bilateral testicular torsion and left testicular resection and right testicular reduction and fixation. Surgical removal of specimens pathological examination were testicular necrosis. Twenty-six patients were followed up for 3 years to 15 years. One case of testicular-free testosterone was low during follow-up. The other 15 cases showed no obvious serum testosterone. Among the 15 cases without excision of the testicle, there were 8 cases in 8 cases (7 cases of ipsilateral testis resection and fixation, the other 1 cases of bilateral testicular torsion, 1 side of testis resection and fixation) in patients with ipsilateral testicular reduction and fixation In one case, the testes with ipsilateral reduction and fixation were mildly reduced compared with those in the same age group. In 14 patients with 14 sides (7 of them underwent orchiectomy and 7 underwent testicular reduction and fixation) Contralateral testicular prophylactic fixation did not prevent the side of testicular torsion, l cases of contralateral prophylactically fixed testis slightly smaller than their peers. In 16 cases, there were 2 cases of oligozoospermia, 1 case of asthenospermia, 1 case of oligozoospermia, and 11 cases of normal semen, except 1 case without azoospermia. One patient without testicular azoospermia, no obvious penile morning erection, severe erectile dysfunction, two patients (one case of asthenospermia, one case of oligozoospermia) mild penile erection Dysfunction, thirteen patients had no erectile dysfunction; 11 patients gave birth to the next generation during follow-up. Conclusions Color Doppler flow imaging is a reliable method to diagnose acute testicular torsion. Early surgical exploration is of great significance to improve testicular survival rate and protect its function.