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目的 :提高睾丸扭转 (精索扭转 )诊治水平。 方法 :回顾分析 1994～ 2 0 0 4年总计 113例睾丸扭转误诊的临床资料。 结果 :首诊误诊率 84 .3%。误诊为急性附睾、睾丸炎 81例 (71.7% ) ;鞘膜积液 10例 (8.8% ) ;急性肠炎 7例 (6 .2 % ) ;泌尿系结石 5例 (4.4 % ) ;腹股沟疝 5例 (4.4 % ) ;睾丸肿瘤 3例 (2 .7% ) ;附睾结核 2例 (1.8% )。发病至误诊时间 2h～ 2个月 ,平均 6 .3d。手法复位成功 3例 ;92例行手术探查 ,睾丸、附睾切除 6 4例 ,睾丸萎缩 2 6例 ,总计睾丸毁损率 79.6 %。 结论 :提高首诊医生对睾丸扭转的诊治水平是减少误诊的关键 ,诊断流程采用病史、体征、彩超 3者结合 ,治疗的最佳方法是积极开展阴囊急诊的手术探查。
Objective: To improve the diagnosis and treatment of testicular torsion (spermatic cord torsion). Methods: The clinical data of 113 cases of misdiagnosis of testicular torsion from 1994 to 2004 were retrospectively analyzed. Results: The first diagnosis of misdiagnosis rate of 84.3%. Misdiagnosed as acute epididymis orchitis 81 cases (71.7%); hydrocele in 10 cases (8.8%); acute enteritis in 7 cases (6.2%); urinary calculi in 5 cases (4.4%); inguinal hernia in 5 cases (4.4%); testicular tumor in 3 cases (2.7%); epididymal tuberculosis in 2 cases (1.8%). The incidence of misdiagnosis time 2h ~ 2 months, an average of 6 .3d. Thirty-three cases were successfully treated by hand manipulation. Surgical exploration was performed in 92 cases. Sixty-four cases of testicular and epididymis resection and twenty-six cases of testicular atrophy were found. Total testicular destruction rate was 79.6%. Conclusion: To improve the diagnosis and treatment of testicular torsion is the key to reduce the misdiagnosis. The diagnostic procedure is based on history, signs and color Doppler. The best way to treat is to actively conduct the operation of scrotal emergency.