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我们通过对11例睾丸扭转的临床分析,得出睾丸扭转误诊率为54.5(6/11),极易误诊为睾丸、附睾炎(4/11);总结了睾丸扭转的4点诊断、鉴别依据:①青少年突发性阴囊或腹股沟疼痛合并睾丸下降不全、睾丸鞘膜积液或其手术史;②患侧阴囊空虚、睾丸上缩至阴囊根部或腹股沟外环口,睾丸触痛明显、质较硬、活动受限,抬高睾丸疼痛加剧,精索增粗且与睾丸附睾解剖关系不清;③无泌尿系症状且尿常规正常;④无肠梗阻症状。指出睾丸扭转时睾丸的存活能力与扭转时间、扭转程度呈双相关系。确定了睾丸扭转的治疗原则是睾丸扭转一经确诊或高度怀疑时,应尽早手术,早期可试行手法复位,并介绍了手法复位的方法及术中判断睾丸活力的方法。
Through the clinical analysis of 11 cases of testicular torsion, we found that the misdiagnosis rate of testicular torsion was 54.5 (6/11), easily misdiagnosed as testicular, epididymitis (4/11); 4 points diagnosis of testicular torsion were summarized and identified : ① adolescent sudden scrotal or groin pain combined with testicular descent, testicular hydrocele or surgical history; ② ipsilateral scrotum empty, testis shrinking to the root of the scrotum or groin outer ring, testicular tenderness significantly, quality comparison Hard, limited mobility, increased testicular pain increased, spermatic cord thickening and unclear relationship between the anatomy of the testis and epididymis; ③ no urinary symptoms and normal urine; ④ no symptoms of intestinal obstruction. Pointed out that testicular torsion testicular survival and torsion time, the degree of torsion showed a biphasic relationship. To determine the principle of treatment of testicular torsion testicular torsion is diagnosed or highly suspected, as soon as possible surgery, early practice can be reset, and describes the method of manipulation and intraoperative judgment of testicular vitality.