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[采用超声检查法和外部线性测量法评估17岁以下男孩睾丸及附睾大小]

[Size of testes and epididymes in boys up to 17 years of life assessed by ultrasound method and method of external linear measurements].

作者信息

Osemlak Paweł

机构信息

Katedra i Klinika Chirurgii i Traumatologii Dzieciecej Uniwersytetu Medycznego w Lublinie.

出版信息

Med Wieku Rozwoj. 2011 Jan-Mar;15(1):39-55.

Abstract

AIMS

  1. Determination of the size of testes and epididymes on the right and left side, in healthy boys in various age groups with use of non-invasive ultrasound examination method and the method of external linear measurements. 2. Determination of age, when intensive growth of testicular and epididymal size starts. 3. Determination whether there are statistically significant differences between the size of the right and the left testis, as well as between the right and left epididymis. 4. Evaluation of the ultrasound method and method of external linear measurements in their use for scientific investigations.

MATERIAL AND METHODS

309 boys, aged from 1 day to 17 years of life, treated in the Clinical Department of Paediatric Surgery and Traumatology of the Medical University in Lublin from 2009 to 2010 due to diseases needed to be treated surgically, but not the scrotum, were examined in this study. No pathologies influencing the development of genital organs were found in these boys. Dimension of the testes was studied with ultrasound method and with method of external linear measurements. Dimension of epididymes was only examined with ultrasound method. In every age group the author calculated mean arithmetical values for: testiscular length, thickness, width and volume, as well as epididymal depth and basis. With consideration of standard deviation (X+/-1 SD) it was possible to define the range of dimension of healthy testes and epididymes and their change with age. Final dimensions of the right and left testis as well as of the right and left epididymis were compared. Dimensions of the testis on the same side of body acquired with the ultrasound method and acquired with the method of external linear measurements were compared. Statistical work-up with Wilcoxon test for two dependent groups was implemented.

RESULTS OF STUDIES

Ultrasound evaluation pointed to intensive 2.5-times increase in testicular length and width, and 2-times increase in testicular thickness in boys aged 10 to 17 years. Mean volume of neonatal testis is 0.35 ml. From 10th year of life, the testicular volume increases 10-times from 1.36 ml to 12.83 ml in 17th year of life. Depth of epididymis measured with ultrasound method is always greater than its basis. Both these dimensions increase quickly from the 10th year of life. Measurements done with the caliper on the average overestimate testicular length by 5.7 mm, its thickness by 2.9 mm and its width by 1.4 mm, comparing with ultrasound method. There were no statistically important differences between dimension of the right and left testis. Differences between dimension of the right and left epididymis are statistically significant.

CONCLUSIONS

  1. Age is the main factor influencing testicular size in boys. 2. Intensive growth of testes starts in the 10th year of life, of epididymes in 12th year of life. 3. Testicular volume is the most precise description of its size. There are no statisticallysignificant differences between volume of the right and left testis. Differences between dimension, described by the depth and basis of the right and left epididymis are statistically significant. 4. Ultrasound method and method of external linear measurements with the caliper have similar diagnostic value in comparing the size of both testes. 5. Measurements of testicular size with ultrasound method have much greater value for detail evaluation than the method of external linear measurements with the caliper, which does not regard thickness of the skin and testicular coats, as well as the epididymal head which is often situated on the upper end of the testis.
摘要

目的

  1. 采用非侵入性超声检查法和外部线性测量法,测定不同年龄组健康男孩左右侧睾丸和附睾的大小。2. 确定睾丸和附睾大小开始快速增长的年龄。3. 确定左右睾丸大小之间以及左右附睾大小之间是否存在统计学上的显著差异。4. 评估超声检查法和外部线性测量法在科学研究中的应用。

材料与方法

本研究对2009年至2010年期间因需手术治疗但非阴囊疾病而在卢布林医科大学小儿外科和创伤科就诊的309名年龄从1天至17岁的男孩进行了检查。这些男孩未发现有影响生殖器官发育的病变。采用超声检查法和外部线性测量法研究睾丸大小。附睾大小仅采用超声检查法。在每个年龄组中,作者计算了以下各项的算术平均值:睾丸长度、厚度、宽度和体积,以及附睾深度和底部。考虑到标准差(X±1 SD),可以确定健康睾丸和附睾的大小范围及其随年龄的变化。比较左右睾丸以及左右附睾的最终大小。比较通过超声检查法和外部线性测量法在身体同一侧获得的睾丸大小。采用Wilcoxon检验对两个相关组进行统计学分析。

研究结果

超声评估显示,10至17岁男孩的睾丸长度和宽度增长了2.5倍,睾丸厚度增长了2倍。新生儿睾丸的平均体积为0.35毫升。从10岁起,睾丸体积从1.36毫升增加到17岁时的12.83毫升,增长了10倍。用超声检查法测量的附睾深度始终大于其底部。这两个维度从10岁起迅速增加。与超声检查法相比,用卡尺测量平均高估睾丸长度5.7毫米、厚度2.9毫米、宽度1.4毫米。左右睾丸大小之间没有统计学上的显著差异。左右附睾大小之间的差异具有统计学意义。

结论

  1. 年龄是影响男孩睾丸大小的主要因素。2. 睾丸在10岁开始快速生长,附睾在12岁开始快速生长。3. 睾丸体积是对其大小最精确的描述。左右睾丸体积之间没有统计学上的显著差异。左右附睾深度和底部所描述的大小差异具有统计学意义。4. 在比较双侧睾丸大小时,超声检查法和用卡尺进行的外部线性测量法具有相似的诊断价值。5. 与用卡尺进行的外部线性测量法相比,超声检查法测量睾丸大小在详细评估方面具有更大的价值,后者未考虑皮肤和睾丸被膜的厚度以及通常位于睾丸上端的附睾头部。

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