儿童睾丸附件扭转手术治疗与保守治疗疗效观察

Observation of Surgical Treatment and Conservative Treatment of Testicular Adnexa Torsion in Children

摘要: 目的：总结儿童睾丸附件扭转患儿的临床特点，探讨手术治疗还是保守治疗对睾丸附件扭转的患儿更有益。方法：回顾性分析2017~2022年期间于重庆医科大学附属儿童医院就诊的睾丸附件扭转患儿的临床资料，分析不同治疗方法的疗效差异。结果：符合入组标准的睾丸附件扭转患儿有89例。发病年龄主要集中在8~11岁。有42例为左侧睾丸附件扭转，47例为右侧睾丸附件扭转。主要临床表现为阴囊疼痛(96.7%)，阴囊红肿(95.5%)、阴囊皮温升高(83.1%)、睾丸上方结节(56.2%)，阴囊外症状如发热(1.1%)、恶心呕吐(0%)极少，提睾反射消失(0%)极少。保守治疗组的治愈率为35.3%，手术治疗组的治愈率为100%；保守治疗组疼痛缓解时间为8.8天，手术治疗组疼痛缓解时间为2.9天；保守治疗组阴囊水肿的消失时间为13.2天，手术治疗组阴囊水肿消失时间为5.6天；保守治疗组治愈后有22例复发，手术治疗组术后随访有0例复发。两者在治愈率、疼痛缓解时间、阴囊水肿消失时间上有统计学差异。结论：睾丸附件扭转患儿手术治疗疗效上优于保守治疗。临床上若因阴囊急诊就诊可积极手术探查。

Abstract: Objective: To summarize the clinical characteristics of testicular adnexal torsion in children, and to explore whether surgical or conservative treatment is more beneficial for these children. Methods: A retrospective analysis was performed on the clinical data of children with testicular adnexal tor-sion treated in Children’s Hospital of Chongqing Medical University from 2017 to 2022, and the effi-cacy of different treatment methods was analyzed. Results: A total of 89 children with testicular adnexal torsion met the inclusion criteria. The age of onset was mainly 8~11 years old. There were 42 cases of left testicular adnexal torsion and 47 cases of right testicular adnexal torsion. The main clinical manifestations were scrotal pain (96.7%), scrotal swelling (95.5%), elevated scrotal skin temperature (83.1%), and nodules above the testis (56.2%). Extra-scrotal symptoms such as fever (1.1%), nausea and vomiting (0%), and absence of testicular reflex (0%) were rare. The cure rate of conservative treatment group was 35.3%, and the cure rate of surgical treatment group was 100%. The pain relief time was 8.8 days in the conservative treatment group and 2.9 days in the surgical treatment group. The disappearance time of scrotal edema was 13.2 days in conservative treatment group and 5.6 days in surgical treatment group. There were 22 cases of recurrence in the conserva-tive treatment group and 0 case of recurrence in the surgical treatment group. There were statisti-cal differences in cure rate, pain relief time and scrotal edema disappearance time between the two groups. Conclusions: Surgical treatment is superior to conservative treatment in children with tes-ticular adnexal torsion. In clinical practice, patients with acute scrotal diseases can be actively ex-plored by surgery.