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 To improve the diagnosis and therapy of acute testicular torsion. Methods The clinical data of 16 patients with 18 testicular torsion ( 2 patients with bilateral testicular torsion) were retrospectively analyzed in the follow-up of 3 years to 15 years. Results Of 16 patients, 7 patients underwent suffering testis restoration-fixation and contralateral preventative testis fixation, 7 patients suffering orchiectomy and contralateral preventative testis fixation, 1 patient bilateral orchidectomy for testicle necrosis, and 1 patient left orchiectomy and right testis restoration-fixation. The pathological examination of resected tissue samples showed testis necrosis. 16 patients were followed up for 3 years to 15 years. 1 patient without testis had lower serum testosterone level and no morning penis erection. The other 15 patients did not show significant serum testosterone abnormality. 8 patients ( 7 patients with suffering testis restoration-fixation, 1 patient with bilateral testicular torsion, left orchiectomy and right testis restoration-fixation ) with 8 suffering testis restoration-fixation had no recurrence of ipsilateral testicular torsion after surgery, in which l patient had postoperative ipsilateral slight reduction of testicular volume compared with that of the men at same age stage. 14 patients ( 7 patients with suffering orchiectomy, 7 patients with suffering testis restoration-fixation ) with 14 contralateral testicular preventive fixation had no ipsilateral testicular torsion, in which l patient had postoperative ipsilateral slight reduction of testicular volume compared with that of the men at same age stage. Semen examination was normal in 11 patients, 2 patients were diagnosed with oligospermia, 1 patients was diagnosed with asthenospermia, 1 patients was diagnosed with oligoasthenospermia, 1 patient without testis was diagnosed with azoospermia. 1 patients (1 patient with azoospermia) had no morning penis erection and severe erectile dysfunction (ED), 2 patients (1 patients with asthenospermia and 1 patients with oligoasthenospermia) had mild ED, 13 patients had no ED. 11 patients gave birth in the follow-up period. Conclusion Color doppler flow imaging is reliable for the diagnosis of acute testicular torsion. Early operative therapy is important for the survival rate of testis and its function protection.
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