阴囊镜在基层医院阴囊急症中的应用
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摘要
目的通过超声和阴囊镜对阴囊急症患者诊断治疗的比较,评估阴囊镜在基层医院阴囊急症中的应用。方法选取2016年3月～2017年3月我院泌尿外科收入的70名阴囊急症患者,采用随机分组的方法分为实验组和对照组,其中实验组35名,采取阴囊镜诊断和治疗;对照组35名,采取超声诊断和治疗。将两组诊断结果与病理诊断对照,比较两组诊断符合率。术后比较两组患者不良并发症的发生情况,以及各项操作所需时间。结果阴囊内窥镜下手术的实验组,术后并发症中炎症肿块、鞘膜积液、静脉曲张的发生率要远远少于传统开放手术的对照组差异具有统计学意义(P <0.05),病理诊断符合率中总诊断符合率、睾丸及附件扭转符合率、附睾炎符合率、附睾精子肉芽肿符合率等显著高于对照组,差异也具有统计学意义(P <0.05);两组睾丸炎的诊断符合率差异不大,统计学意义(P>0.05)。手术时间中实验组囊肿穿刺注药、睾丸穿刺活检、脓肿切开引流、输精管栓堵所需要的时间实验组均明显少于对照组,差异均具有统计学意义(P <0.05)。结论阴囊内窥镜在阴囊急症中具有提高诊断准确率和降低手术并发症的优点,值得临床推广。
Objective Through the comparison of ultrasound and scrotal mirror in the diagnosis and treatment of scrotal emergency patients, the application of scrotal mirror in the scrotum emergency of primary hospital was evaluated.Methods A total of 70 patients with scrotal emergency were randomly divided into two groups: 35 patients in the experimental group(35 patients treated with scrotal lens and 35 patients in the control group)(Ultrasound diagnosis and treatment), the two diagnostic results and pathological diagnosis of comparison, compared the diagnostic rate of the two. The incidence of adverse complications was compared between the two groups, and the time required for each operation was compared. Results In the two groups of patients with postoperative complications, scrotal endoscopic surgery group,postoperative complications of inflammation, lumps, hydrocele, varicose veins to be far less than the traditional open surgery control group, Pathological diagnosis of the total diagnostic rate of compliance, testicular and annex to reverse,epididymitis, epididymal sperm granuloma, the other significantly higher than the control group, the accuracy of the diagnostic rate of orchitis is not the same time, the experimental group of cyst injection(P <0.05). The time required for puncture biopsy, abscess incision and drainage, and vasectomy were significantly lower than those of the control group. The difference was statistically significant(P <0.05). Conclusions Scrotal endoscopy in the scrotum emergency has improved diagnostic accuracy, reduce the advantages of surgical complications, worthy of clinical promotion.
Objective Through the comparison of ultrasound and scrotal mirror in the diagnosis and treatment of scrotal emergency patients, the application of scrotal mirror in the scrotum emergency of primary hospital was evaluated.Methods A total of 70 patients with scrotal emergency were randomly divided into two groups: 35 patients in the experimental group(35 patients treated with scrotal lens and 35 patients in the control group)(Ultrasound diagnosis and treatment), the two diagnostic results and pathological diagnosis of comparison, compared the diagnostic rate of the two. The incidence of adverse complications was compared between the two groups, and the time required for each operation was compared. Results In the two groups of patients with postoperative complications, scrotal endoscopic surgery group,postoperative complications of inflammation, lumps, hydrocele, varicose veins to be far less than the traditional open surgery control group, Pathological diagnosis of the total diagnostic rate of compliance, testicular and annex to reverse,epididymitis, epididymal sperm granuloma, the other significantly higher than the control group, the accuracy of the diagnostic rate of orchitis is not the same time, the experimental group of cyst injection(P <0.05). The time required for puncture biopsy, abscess incision and drainage, and vasectomy were significantly lower than those of the control group. The difference was statistically significant(P <0.05). Conclusions Scrotal endoscopy in the scrotum emergency has improved diagnostic accuracy, reduce the advantages of surgical complications, worthy of clinical promotion.
引文
1尹焯,杨金瑞,王钊,等.阴囊镜在睾丸附睾疾病诊断与治疗中的应用.北京大学学报(医学版)2015;47(4):648-652.
2 Ta Anthony,D Arcy Frank T,Hoag Nathan,D'Arcy John P,Lawrentschuk Nathan.Testicular torsion and the acute scrotum:currentemergencymanagement.EurJ Emerg Med:Official J Eur Soc EmergMed 2016;23(3):10-13.
3许云峰,蒋海燕,胡慧勇,等.高频彩超对小儿阴囊急症的诊断及鉴别诊断价值.中华男科学杂志,2016,22(11):996-1000.
4 Anthony Ta,Frank T.D’Arcy,Nathan Hoag,John P.D’Arcy,Nathan Lawrentschuk.Testicular torsion and the acute scrotum:current emergency management.Eur J Emerg Med 2016;23(3):15-20.
5张胜林,陈英银,陈声亮,等.彩色多普勒超声在青少年阴囊急症中的应用价值.海南医学2015;26(15):2253-2256.
6 Laura Lorenzo,Ramon Rogel,Jose V.Sanchez-Gonzalez,Javier Perez-Ardavin,Elena Moreno,Saturnino Lujan,Enrique Broseta,Francisco Boronat.Evaluation of Adult A-cute Scrotum in the ER:Clinical Characteristics,Diagnosis,Management and Costs.Urology 2016;
7叶华茂,刘智勇,许传亮,等.阴囊镜技术在睾丸扭转早期诊断中的应用.微创泌尿外科杂志2013;2(2):117-118
8黄莉梅,谢文锋.彩超诊断阴囊急症的价值.现代医院2013;13(11):63-65
9苏新军.阴囊镜检查在慢性睾丸痛诊治中的应用研究.浙江省医学会男科学分会2014:2
10 Bauer Natasha J G.Case report:Traumatic unilateral testicular rupture.Int J Surg Case Rep 2016;25
11陈晨,杨杰,秦远,等.阴囊镜治疗附睾囊肿症1例报道.南京医科大学学报(自然科学版)2017;37(5):647-648
12邱建民,潘敏莉,李盈盈,等.阴囊急症的彩色多普勒超声诊断价值.赣南医学院学报2013;33(3):333-335
13江涛,赖全图,王卫真,等.彩色多普勒超声诊断阴囊急症163例分析.南昌大学学报(医学版),2014,54(6):89-90+107.
14张洋,陈争光,郑权.高频彩色多普勒超声检查诊断阴囊急症的临床价值.山东医药2016;56(12):86-87
2 Ta Anthony,D Arcy Frank T,Hoag Nathan,D'Arcy John P,Lawrentschuk Nathan.Testicular torsion and the acute scrotum:currentemergencymanagement.EurJ Emerg Med:Official J Eur Soc EmergMed 2016;23(3):10-13.
3许云峰,蒋海燕,胡慧勇,等.高频彩超对小儿阴囊急症的诊断及鉴别诊断价值.中华男科学杂志,2016,22(11):996-1000.
4 Anthony Ta,Frank T.D’Arcy,Nathan Hoag,John P.D’Arcy,Nathan Lawrentschuk.Testicular torsion and the acute scrotum:current emergency management.Eur J Emerg Med 2016;23(3):15-20.
5张胜林,陈英银,陈声亮,等.彩色多普勒超声在青少年阴囊急症中的应用价值.海南医学2015;26(15):2253-2256.
6 Laura Lorenzo,Ramon Rogel,Jose V.Sanchez-Gonzalez,Javier Perez-Ardavin,Elena Moreno,Saturnino Lujan,Enrique Broseta,Francisco Boronat.Evaluation of Adult A-cute Scrotum in the ER:Clinical Characteristics,Diagnosis,Management and Costs.Urology 2016;
7叶华茂,刘智勇,许传亮,等.阴囊镜技术在睾丸扭转早期诊断中的应用.微创泌尿外科杂志2013;2(2):117-118
8黄莉梅,谢文锋.彩超诊断阴囊急症的价值.现代医院2013;13(11):63-65
9苏新军.阴囊镜检查在慢性睾丸痛诊治中的应用研究.浙江省医学会男科学分会2014:2
10 Bauer Natasha J G.Case report:Traumatic unilateral testicular rupture.Int J Surg Case Rep 2016;25
11陈晨,杨杰,秦远,等.阴囊镜治疗附睾囊肿症1例报道.南京医科大学学报(自然科学版)2017;37(5):647-648
12邱建民,潘敏莉,李盈盈,等.阴囊急症的彩色多普勒超声诊断价值.赣南医学院学报2013;33(3):333-335
13江涛,赖全图,王卫真,等.彩色多普勒超声诊断阴囊急症163例分析.南昌大学学报(医学版),2014,54(6):89-90+107.
14张洋,陈争光,郑权.高频彩色多普勒超声检查诊断阴囊急症的临床价值.山东医药2016;56(12):86-87