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隐睾症:对1984年至1988年连续7500例男性出生病例的前瞻性研究。约翰·拉德克利夫医院隐睾症研究小组。

Cryptorchidism: a prospective study of 7500 consecutive male births, 1984-8. John Radcliffe Hospital Cryptorchidism Study Group.

出版信息

Arch Dis Child. 1992 Jul;67(7):892-9. doi: 10.1136/adc.67.7.892.

Abstract

A total of 7441 boys were examined for cryptorchidism at birth and, if present, again at 3 months of age. After excluding boys with severe congenital malformations noted at birth, the cryptorchidism rates at 3 months in babies weighing less than 2000 g, 2000-2499 g, and greater than or equal to 2500 g were 7.7%, 2.5%, and 1.41% respectively. The overall rate was 1.55%. The cryptorchidism rate at birth had increased by 35.1% and at 3 months by 92.7%, over Scorer's rates in the 1950s. Part of these increases may be attributable to differences in neonatal mortality, but the increases in babies weighing 2500 g or more of 50.2% at birth and 77.4% at 3 months are unlikely to be overestimates. At birth 1.92% of boys had bilateral cryptorchidism and 3.0% unilateral cryptorchidism. Boys with cryptorchidism at 3 months were more likely to have hypospadias, a small scrotum, and poor scrotal rugation compared with boys having normally descended testes at birth. Factors predicting descent by 3 months in babies cryptorchid at birth are birth weight, laterality and scrotal size, babies with low birth weight, bilateral cryptorchidism, and normal scrotal size being more likely to have normally descended testes by 3 months. Descent by 3 months was more likely the lower the testis along the normal pathway of descent. The orchidopexy rate at an average age of 3 years was 1.24%. This is substantially lower than in other series and lower than our estimated rate of 2.9% using Hospital In-Patient Enquiry data for England and Wales.

摘要

共有7441名男婴在出生时接受了隐睾症检查,若有隐睾,在3个月大时再次检查。在排除出生时发现有严重先天性畸形的男婴后,体重小于2000克、2000 - 2499克以及大于或等于2500克的婴儿在3个月时的隐睾症发生率分别为7.7%、2.5%和1.41%。总体发生率为1.55%。与20世纪50年代斯考勒报告的发生率相比,出生时隐睾症发生率增加了35.1%,3个月时增加了92.7%。这些增加部分可能归因于新生儿死亡率的差异,但体重2500克及以上婴儿出生时增加50.2%、3个月时增加77.4%,不太可能是高估。出生时,1.92%的男婴为双侧隐睾,3.0%为单侧隐睾。与出生时睾丸正常下降的男婴相比,3个月时患有隐睾症的男婴更易出现尿道下裂、阴囊小以及阴囊皱襞差。预测出生时患有隐睾症的婴儿在3个月时睾丸下降的因素有出生体重、单侧或双侧以及阴囊大小,出生体重低、双侧隐睾且阴囊大小正常的婴儿在3个月时睾丸更有可能正常下降。在正常下降路径上,睾丸位置越低,在3个月时下降的可能性越大。平均3岁时的睾丸固定术发生率为1.24%。这大大低于其他系列报道,也低于我们利用英格兰和威尔士医院住院病人查询数据估计的2.9%的发生率。

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