Van Glabeke E, Khairouni A, Larroquet M, Audry G, Gruner M
Service de Chirurgie Viscérale Infantile et Néonatale, Hôpital d'Enfants Armand-Trousseau, Paris, France.
Prog Urol. 1998 Apr;8(2):244-8.
Definition of prognostic factors for torsion of the testis in children.
From January 1986 to December 1996, 91 children were operated for torsion of the testis. Torsions were observed at all ages of childhood, but with two frequency peaks: during the neonatal period and in adolescence. Typical clinical features were observed in only three-quarters of cases.
Thirty-nine testes were considered to be necrotic versus 52 with a chance of recovery. Factors of poor prognosis were: neonatal forms, delayed management or tight torsion with several turns. 28 of the necrotic testes were conserved: two were complicated by purulent necrosis, but 14% retained normal trophicity on long-term examination.
The possibility of torsion at all ages of childhood and the frequently incomplete clinical features means that emergency surgical exploration must always be performed in the case of testicular pain. A conservative attitude is motivated by the possibility of recovery of testes considered to be necrotic at operation.
明确儿童睾丸扭转的预后因素。
1986年1月至1996年12月，91例儿童因睾丸扭转接受手术。睾丸扭转在儿童各年龄段均有发生，但有两个高发期：新生儿期和青春期。仅四分之三的病例观察到典型临床特征。
39个睾丸被认为已坏死，52个有恢复机会。预后不良的因素包括：新生儿型、治疗延迟或扭转严重且扭转多圈。28个坏死睾丸被保留：其中2个并发脓性坏死，但长期检查发现14%的睾丸保留了正常的营养状态。
儿童各年龄段均可能发生睾丸扭转，且临床特征常不完整，这意味着在出现睾丸疼痛时必须始终进行急诊手术探查。对于术中被认为已坏死的睾丸，鉴于其仍有恢复的可能性，可采取保守态度。
