小儿阴囊急症（附526例报告）

Acute scrotum in children(report of 526 cases)
<<中华泌尿外科杂志 >>2000年11期
何大维 , 林涛 , 龚以榜 , 李旭良 , 魏光辉

目的　总结小儿阴囊急症手术或非手术治疗的可行性。　方法　回顾性研究526例小儿阴囊急症患者的临床资料和诊疗经验。睾丸附件扭转368例(70.0%)，急性鞘膜炎49例(9.4%)，睾丸扭转42例(8.0%)，急性附睾炎19例(3.5%)，急性阴囊感染18例(3.4%)，阴囊血肿18例(3.4%)，睾丸炎6例(1.1%)，特发性阴囊水肿6例(1.1%)。前4种常见疾病共478例，占90.9%。住院前误诊223例(42.4%)。　结果　急诊手术探查473例(89.9%)，术中发现扭转附件部分或全部坏死，鞘膜增厚，睾丸扭转者中33个(33/42)睾丸梗死，术后疼痛症状减轻，肿胀消退。　结论　小儿阴囊急症的正确诊断和治疗十分重要，应积极行手术探查。
Objective　To evaluate urgent surgical exploration for acute scrotum in children.　Methods　526 cases of acute scrotum in children were reviewed.There were 368(70.0%) cases of torsion of the appendix testis,49(9.3%) idiopathic pyoceles,42(8.0%) testicular torsion,19(9.3%) acute epididymitis,18(3.4%) scrotal infection,18(3.4%) scrotal hematoma,6(1.1%) acute orchitis and 6(1.1%) idiopathic scrotal edema.The most common 4 conditions accounted for 90.9%(478/526),42.4%of which have been misdiagnosed (223/526).　Results　473 patients (89.9%) underwent urgent surgical exploration.Partial or complete necrosis of the distorted appendix testis has been often found.In 42 cases of testicular distorsion,necrosis due to embolism occurred in 33.Pain and edema of the scrotum usually decreased after operation.　Conclusions　Prompt surgical exploration for acute scrotum in children is often necessary in order to make the diagnosis accurate and the treatment appropriate.

关键词： 阴囊　　急症　　诊断　　治疗