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1、睾丸扭转的诊断与治疗【摘要】目的：探讨睾丸扭转的早期诊断和治疗，以提高患者的睾丸成活率。方法：对18例睾丸扭转患者的临床资料进行回顾性分析，18例患者行彩色多普勒超声检查和手术探查，其中8例患者行睾丸切除术，10例行睾丸复位固定术，所有病例均行对侧睾丸探查固定术。结果：18例中初诊确诊为睾丸扭转者11例，误诊为急性睾丸附睾炎7例，彩超诊断符合率为100%;18例患者均痊愈,发病<12h6例均保留睾丸，术后睾丸均成活;发病12〜24h5例，保留睾丸4例，1例睾丸坏死行切除术;发病>24h7例均为睾丸坏死而行睾
2、丸切除术。随访1〜5年，10例保留睾丸的患者中,6例患者彩超显示睾丸形态和血流正常；3例出现患侧睾丸轻微萎缩，但对侧睾丸血流正常；1例患者患侧睾丸明显萎缩。8例切除睾丸患者彩超显示对侧睾丸血流正常。结论：彩超是睾丸扭转首选检查方法，早期诊断、及时手术探查是提高患者睾丸成活率的关键。睾丸扭转12h以内均应行睾丸复位固定术，12〜24h应尽量保留睾丸，超过24h应切除睾丸。【关键词】睾丸扭转；早期诊断;外科治疗;成活[ABSTRACT]Objective:Toevaluatetheearlydiagnosisandtrea
3、tmentoftesticulartorsion，andtoimprovethesurvivalrateoftesticulartorsion・Methods:Clinicaldataof18patientswithtesticulartorsionwereanalyzedretrospectively.AllpatientswereexaminedwithcolorDopplerultrasonographyandunderwentsurgicalexploration,8patientsunderwentteste
4、ctomy,10patientsunderwenttesticularreductionandfixation,andallpatientsunderwentsurgicalexplorationandfixationofcontralateraltestis・Results:Ofthe18patientswithtesticulartorsion,11casesweredefinitelydiagnosedatfirstvisit,andtheother7casesweremisdiagnosedasacutetes
5、ticularepididymitis,theconformityrateofdiagnosisofcolorDopplerultrasonographywas100%,al1patientswerecured.Of6patientswithepisodetime&It;12h,theirtesteswereretainedandal1thetestessurvived;of5patientswithepisodetime12~24h,testesof4caseswereretained,onepatienfstest
6、iswasexcisedduetotesticularnecrosis;of7patientswithepisodetime>24h,theirtesteswereexcisedduetotesticularnecrosis・Accordingtofollowupof1to5years,ofthe10patientswithretainedtestesexaminedwithcolorDopplerultrasound,6casesshowednormaltesticularmorphologyandbloodf
7、lowsupply;3patients9stestesoccurredmildatrophy,butthecontralateraltesticularbloodflowwasnormal;onepatienfstestisoccurredmarkedatrophy.Contralateraltesticularbloodflowofthe8patientswithonetestisresectedwasnormalaccordingtocolorDopplerultrasonography.Conclusion:Co
8、lorDopplerultrasonographyisthepreferredexaminationoftesticulartorsion,earlydiagnosisandtimelysurgicalexplorationarekeytoimprovethesurvivalrate・Ofthetreatmentoftesticu
