摘要
自1988年9月至1993年7月，共有23位病人因疑似睪丸扭轉而接受睪丸探查手術。術後有17位病人證實為睪丸扭轉，有5位病人是副睪和/或睪丸炎，有一位病人是嵌塞性腹股溝疝氣。我們的病人大部分睪丸扭轉的發生是在10~20歲，左側睪丸比右側睪丸多見(11:6)。在17位病人中有14位是發生是在11月至4月間天冷的季節。約有70。60%的病人呈白血球升高。而診斷的方法可使用核醫陰囊掃描，杜卜勒聽診器或彩色杜卜勒超音波檢查。手術中有11位病人(82.4%)因睪丸壞死而接受睪丸切除術，其餘6位病人的睪丸則能保存下來。睪丸切除率過高的主要原因是病人延誤就診時間。越早手術探查，越可降低睪丸切除率。所以教育民眾了解睪丸扭轉的嚴重性是很重要的。 有三位睪丸扭轉的病人於後曾接受抗精蟲抗體的測試，其中有一位病人有陽性反應。這結果表示睪丸扭轉可能導致自體免疫反應的發生。
並列摘要
From September 1988 to July 1993, 23 patients underwent testicular exploration under suspicion of testicular torsion. Testicular torsions in 17 of patients, epididymitis and/or orchitis in 5 patients, and incarcerated inguinal hernia in 1 patient were found. Most of the patients had testicular torsion which had occurred between the ages of 10-20years. The left testis was more frequently involved than the right (11:6). Fourteen patients (82.4%) had testicular torsion occurring between the months of November to April. About 70.6% of the patients showed leukocytosis. Diagnostic studies included scrotal scan, Doppler stethoscope or color duplex ultrasonogram. Scrotal scan and color duplex ultrasnogram had a higher predictive positive rate than Doppler stethoscope, but they were costly procedures and the scan can not usually be performed in an emergency. Surgical exploration was immediately performed in all patients when testicular torsion was suspected. At exploration, orchiectomy was performed in 11 patients (67.4%) due to gangrenous changes of the affected testis. In the other six patients the testes were salvaged. Poor testicular salvage rate was the result of delayed presentation at this department in most cases. Positive antisperm antibody was noted in one of three patients during follow-up, suggesting that autoimmune response may be induced after testicular torsion.
延伸閱讀
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