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小儿急性附睾炎的临床特征:一家机构对142例病例的回顾

Clinical characteristics of pediatric acute epididymitis: a single institute review of 142 cases.

作者信息

Furugane Ryoya, Mitsunaga Tetsuya, Komatsu Shugo, Takenouchi Ayako, Oita Satoru, Kawaguchi Yunosuke, Kudo Wataru, Nishimura Katsuhiro, Hishiki Tomoro

机构信息

Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba, 260-8677, Japan.

出版信息

Pediatr Surg Int. 2025 Aug 30;41(1):278. doi: 10.1007/s00383-025-06168-7.

Abstract

PURPOSE

Acute epididymitis (AE) is a common cause of scrotal pain and swelling in children; however, its etiology and risk factors for poor outcomes remain unclear. This study aimed to identify the clinical characteristics and potential risk factors associated with poor AE outcomes.

METHODS

We retrospectively reviewed pediatric patients with AE treated at our hospital. Clinical data, laboratory results, ultrasonographic findings, and treatment strategies were analyzed. We conducted comparative analyses to identify significant risk factors linked to poor outcomes.

RESULTS

A total of 142 patients with a median age of 9 years were reviewed. Of these, 137 cases had favorable testicular outcomes, while five cases had poor outcomes, including three cases of testicular or epidydimal atrophy, one case of testicular necrosis, and one case of testicular necrosis and abscess. Fever (p = 0.001), C-reactive protein (CRP) levels (p = 0.002), and decreased testicular blood flow on ultrasonography (p < 0.001) were significantly associated with poor testicular outcomes.

CONCLUSION

Fever, CRP levels, and decreased testicular blood flow are risk factors for unfavorable testicular outcomes in pediatric patients with AE. Patients with these risk factors require careful monitoring and may benefit from aggressive management strategies.

摘要

目的

急性附睾炎(AE)是儿童阴囊疼痛和肿胀的常见原因;然而,其病因及预后不良的危险因素仍不清楚。本研究旨在确定与AE预后不良相关的临床特征和潜在危险因素。

方法

我们回顾性分析了在我院接受治疗的AE患儿。分析了临床资料、实验室检查结果、超声检查结果及治疗策略。我们进行了比较分析,以确定与预后不良相关的显著危险因素。

结果

共纳入142例患儿,中位年龄9岁。其中,137例患儿睾丸预后良好,5例预后不良,包括3例睾丸或附睾萎缩、1例睾丸坏死、1例睾丸坏死伴脓肿。发热(p = 0.001)、C反应蛋白(CRP)水平(p = 0.002)及超声检查显示睾丸血流减少(p < 0.001)与睾丸预后不良显著相关。

结论

发热、CRP水平及睾丸血流减少是AE患儿睾丸预后不良的危险因素。有这些危险因素的患儿需要密切监测,积极的治疗策略可能对其有益。

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