目的探讨睾丸组织出血分级评估睾丸扭转患睾活力的可靠性。方法对15例确诊为睾丸扭转患者,根据Arda的三级评分系统,按活检切口有无出血及出血出现的时间分为三级。Ⅰ级:出血明显而迅速;Ⅱ级:10分钟内有出血;Ⅲ级:10分钟内无出血。以组织病理诊断作参考标准。结果15例患者中,Ⅲ级出血者5例均行睾丸切除。Ⅱ级者4例予以保留睾丸,其中2例分别于术后1个月、3个月发生睾丸萎缩,经再次手术切除睾丸。6例Ⅰ级出血者均行睾丸固定术,术后随访睾丸大小及血流无异常。组织病理结果与出血分级结果具有较高的一致性。6例出血Ⅰ级者组织病理均为出血型,而5例出血Ⅲ级者均为坏死型,4例出血Ⅱ级者中2例为坏死型、2例为混合型,其中分别有1例坏死型、1例混合型术后发生睾丸萎缩。结论睾丸组织出血分级可作为判断睾丸扭转患睾活力的参考指标及术中是否保留睾丸的依据。 Objective To investigate the reliability of testicular tissue hemorrhage grading in assessing testicular torsion testis activity. Methods Fifteen patients diagnosed as having testicular torsion were divided into three grades according to Arda ’s three - grade scoring system according to whether the biopsy incision had bleeding or bleeding. Ⅰ grade: bleeding was obvious and rapid; Ⅱ grade: bleeding within 10 minutes; Ⅲ grade: no bleeding within 10 minutes. Histopathological diagnosis as a reference standard. Results Among the 15 patients, grade Ⅲ hemorrhage in 5 patients underwent orchiectomy. Grade Ⅱ 4 cases to retain the testis, of which 2 cases were 1 month after surgery, 3 months of testicular atrophy, after resection of the testis. Six cases of grade I bleeding were performed testicular fixation, follow-up testicular size and blood flow was normal. Histopathological and bleeding grading results with higher consistency. The histopathology of the 6 patients with grade Ⅰ bleeding was hemorrhagic, while 5 with hemorrhage Ⅲ grade were necrotic, 2 of 4 with hemorrhage Ⅱ were necrotic and 2 with mixed type, of which 1 was necrotic Type, 1 case of mixed type of testicular atrophy occurred. Conclusion The testicular tissue hemorrhage grading can be used as a reference index to judge the testicular torsion suffering from testicular activity and whether to retain testicular basis.