CAJ | 학술논문

目的探讨新生儿睾丸扭转发生的特点及治疗时机选择.方法回顾性分析近10年新生儿睾丸扭转患儿可能的致病危险因素、临床特点、超声检查结果、治疗策略、病理结果及术后随访情况.结果新生儿睾丸扭转共17例,左侧7例,右侧10例;其中剖腹产11例(65%),第二产程延长5例(29%),羊水过少2例(12%);术前体检均发现睾丸增大,多伴有阴囊色泽改变(94%).超声检查均发现患睾体积增大、回声不均或增强、血流信号减小或消失.术中探查打开肉膜组织后均发现精索睾丸扭转并已坏死而行患睾切除,其中14例行对侧睾丸固定术.所有患睾病理活检均提示睾丸坏死,7例(41%)可见钙化灶.所有随诊病例超声检查未发现对侧睾丸异常.结论新生儿睾丸扭转失睾率极高;当发现阴囊色泽改变、睾丸增大等改变,即应考虑睾丸扭转可能;超声检查敏感性高,可作为首选检查方法;患儿出生过程出现异常可能是新生儿睾丸扭转的诱因.
목적 탐토신생인고환뉴전발생적특점급치료시궤선택.방법 회고성분석근10년신생인고환뉴전환인가능적치병위험인소、림상특점、초성검사결과、치료책략、병리결과급술후수방정황.결과 신생인고환뉴전공17례,좌측7례,우측10례;기중부복산11례(65%),제이산정연장5례(29%),양수과소2례(12%);술전체검균발현고환증대,다반유음낭색택개변(94%).초성검사균발현환고체적증대、회성불균혹증강、혈류신호감소혹소실.술중탐사타개육막조직후균발현정색고환뉴전병이배사이행환고절제,기중14례행대측고환고정술.소유환고병리활검균제시고환배사,7례(41%)가견개화조.소유수진병례초성검사미발현대측고환이상.결론 신생인고환뉴전실고솔겁고;당발현음낭색택개변、고환증대등개변,즉응고필고환뉴전가능;초성검사민감성고,가작위수선검사방법;환인출생과정출현이상가능시신생인고환뉴전적유인.
Objective To investigate the clinical characteristics and management of neonatal testicular torsion. Methods Neonatal testicular torsion were reviewed focusing on the possible risk factors, clinical features, ultrasonic characteristics, management, pathological outcome and follow-up results. Results A total of 17 neonatal testicular torsion (left side 7, right side 10) was diagnosed. 11cases of them were cesarean delivery (65 %). 5 cases were found a prolonged second stage of labor (29%), and 2 cases with oligohydramnios (12%) before birth. All patients presented an enlarged testes. Most of them presented with scrotal discoloration (94%). Ultrasound examination showed enlargment of testicular volum, heterogeneity and lacked of blood flow. The twisted testes and spermatic cord showed necrosis intra-operatively. Orchiectomy was carried out. Orchidopexy on contralateral testis was performed in 14 cases. Pathology of ipsilateral testes showed necrosis, and calcification occurred in 7 cases(41 %). All contralateral testes presented normal Ultrasound image during the followup. Conclusions The rate of testicular necreosis was high in neonatal testicular torsion. Testicular torsion should be suspected when neonatal testis presents scrotal discoloration and enlarged testicular mass. Ultrasound inspection is a sensitive method in diagnosing neonatal testis torsion, and should be recommended. Abnormal labor may lead to the neonatal testis torsion.