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突然腹痛，小心睪丸扭轉(zhuǎn)而“扯蛋”
牛大夫
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工作就用美篇工作版","img_beautify_switch":0,"ad_free":0,"text_direction":1,"template":{"id":9044,"series_id":18,"theme_id":18},"container":{},"redirect":{"redirect_type":1,"img_url":false,"link_url":"\/wap\/downloadpage\/backpage","button_bg_color":false,"button_desc":false,"redirect_desc":false},"edit_date_str":"更新于 2017-06-23","current_time":1776234910,"font_name":"","rcmd_meipian":0,"hide_article_link":0,"from_wechat":false,"music_name":"","origin_status":0,"password_v2":"","font_id":0,"title_style":"","rich_text_title":"","enable_download":1,"cover_thumb":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/06a27826f002489d8fb94f486aac163d_crop__jpg.heic","has_video":false,"gift_switch":1,"enable_watermark":0,"content":{"article_id":49422094,"content":[{"text":"<h3>近日，連續(xù)兩例突然腹痛的患兒，因基層或非專業(yè)醫(yī)師缺乏對\"睪丸扭轉(zhuǎn)\"了解和認識，導(dǎo)致患兒不得不做一側(cè)睪丸切除手術(shù)。造成終身遺憾！<\/h3>"},{"text":"<h3>日常生活中，不少患者對睪丸扭轉(zhuǎn)麻痹大意，疼痛時一忍再忍，以致延誤了早期治療，個別人因此喪失生育能力，釀成終生不幸。因此，青春期及其前后的患者如突然出現(xiàn)陰囊腫脹、疼痛，尤其是青少年，應(yīng)考慮到睪丸扭轉(zhuǎn)的可能，要及時去醫(yī)院泌尿外科檢查診治。此外，如果不幸發(fā)生睪丸扭轉(zhuǎn)，治療后要請醫(yī)生做精液常規(guī)檢查，以了解病側(cè)睪丸及對側(cè)睪丸的功能，這一點對未婚男青年顯得更為重要。<\/h3>"},{"img_height":470,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/51d9f7cd24964310bcc37a6f201023c2__jpg.heic","img_width":474,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi81MWQ5ZjdjZDI0OTY0MzEwYmNjMzdhNmYyMDEwMjNjMl9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>什么是睪丸扭轉(zhuǎn)？臨床表現(xiàn)常見癥狀是什么？<\/h3><h3>睪丸通過睪丸系膜與陰囊相連，由睪丸系膜將睪丸固定于陰囊。有的胎兒在發(fā)育時會產(chǎn)生一側(cè)或兩側(cè)睪丸系膜過長，出生后，睪丸與精索的活動度就很大，如果突然遇上用力或猛烈震蕩等情況，睪丸與精索就會發(fā)生一定程度的扭轉(zhuǎn)，也叫精索扭轉(zhuǎn)。<\/h3><h3>臨床表現(xiàn)：<\/h3><h3>1.腹部突然出現(xiàn)劇痛。<\/h3><h3>2.睪丸出現(xiàn)劇痛。<\/h3><h3>3.發(fā)生扭轉(zhuǎn)的睪丸在陰囊內(nèi)的位置顯得較正常睪丸高一些。<\/h3><h3>4.患兒可能會出現(xiàn)惡心、嘔吐。<\/h3><h3>5.癥狀出現(xiàn)數(shù)小時后，陰囊會紅腫、觸痛。<\/h3>"},{"img_height":1100,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/b7bd9eef18fc4f81a0abbbc280b601a7__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi9iN2JkOWVlZjE4ZmM0ZjgxYTBhYmJiYzI4MGI2MDFhN19fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>診斷：<\/h3><h3>1.常見于青少年，而18歲以下青少年除了急性腮腺炎、睪丸炎以外發(fā)生附睪睪丸炎的機會較少。青少年陰囊急癥應(yīng)首先考慮睪丸扭轉(zhuǎn)。<\/h3><h3>2.很多患者為睡眠中或劇烈活動后發(fā)病，睪丸扭轉(zhuǎn)40%左右發(fā)生于安靜或睡眠中?？赡苡谒邥r迷走神經(jīng)興奮，提睪肌收縮頻率增加，睡眠中不斷改變姿勢或擠壓睪丸造成扭轉(zhuǎn)；<\/h3><h3>3.一般疼痛在前，漸進性睪丸或附睪腫大在后；<\/h3><h3>4.<72h患者多數(shù)無發(fā)熱；<\/h3><h3>5.既往有類似疼痛發(fā)作史，持續(xù)時間短，一旦扭轉(zhuǎn)復(fù)位后疼痛立即消失；<\/h3><h3>6.發(fā)病早期常因提睪肌痙攣而精索縮短，睪丸向上移位或呈橫位或附睪位置異常；<\/h3><h3>7.托起陰囊，疼痛不減輕反而加重<\/h3><h3>8.提睪肌反射消失：是診斷睪丸扭轉(zhuǎn)最敏感的指標，提睪反射存在可排除睪丸扭轉(zhuǎn)<\/h3><h3>9.彩色多普勒檢查CDFI檢查有特異性<\/h3>"},{"img_height":1600,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/66eb725b3f5a4840a47ff9f2d9f1e148__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi82NmViNzI1YjNmNWE0ODQwYTQ3ZmY5ZjJkOWYxZTE0OF9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>治療<\/h3><h3>復(fù)位越早越好，對睪丸扭轉(zhuǎn)的治療要爭分奪秒，一旦確診或高度懷疑本病時應(yīng)迅速果斷地實施探查術(shù)，以保留和挽救睪丸，保護生精功能。<\/h3>"},{"img_height":900,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/948a4930ffb544f2acab8d0cd37ef0ea__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi85NDhhNDkzMGZmYjU0NGYyYWNhYjhkMGNkMzdlZjBlYV9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>手法復(fù)位<\/h3><h3>有人認為，在積極術(shù)前準備的同時，可試行手法復(fù)位，更能快捷的解救缺血的睪丸，挽救睪丸功能，為手術(shù)復(fù)位贏得時間。但超過6h的扭轉(zhuǎn)由于睪丸附睪出現(xiàn)不同程度的腫大、淤血，精索扭轉(zhuǎn)處增粗、水腫，甚至發(fā)生粘連，故不宜手法復(fù)位。行手法復(fù)位時要準確判斷扭轉(zhuǎn)的方向和程度。否則會加重和延誤病情。一般左側(cè)睪丸多為逆時針方向扭轉(zhuǎn)，右側(cè)多為順時針方向扭轉(zhuǎn)。一旦復(fù)位方向正確，復(fù)位成功，能迅速恢復(fù)睪丸血運，患者局部疼痛可很快減輕或消失。不論復(fù)位成功與否，都應(yīng)立即施行手術(shù)復(fù)位或固定術(shù)。<\/h3>"},{"img_height":1328,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/7f47823c44024a73b7f599321c620fd6__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi83ZjQ3ODIzYzQ0MDI0YTczYjdmNTk5MzIxYzYyMGZkNl9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>手術(shù)治療：<\/h3><h3>1.睪丸固定：術(shù)中探查復(fù)位，如睪丸白膜無缺血性改變，切除部分鞘膜，將睪丸前、后、下各固定1針，精索與外周組織固定2針。<\/h3><h3>2.部分切除：對白膜呈紫斑點狀的，可試行切開白膜向睪丸門方向逐步剔除壞死組織，如遇到有新鮮出血即可留下殘留組織<\/h3><h3>3.行睪丸切除時在白膜內(nèi)切除壞死組織，保留白膜等殘留結(jié)構(gòu)，減輕患者的心理負擔。 <\/h3>"},{"img_height":622,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/fbb71a84f7704549bd0f5b5efad2478a__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi9mYmI3MWE4NGY3NzA0NTQ5YmQwZjViNWVmYWQyNDc4YV9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>遵循原則：<\/h3><h3>1.睪丸生機判斷不清時一律切除；<\/h3><h3>2.扭轉(zhuǎn)時間>24h者一律切除；<\/h3><h3>3.扭轉(zhuǎn)>360°、時間>12h或扭轉(zhuǎn)>720°、時間>6h者一律切除。<\/h3>"},{"img_height":458,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/6792f450faac4e7eb4af24b21b65ee44__jpg.heic","img_width":538,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi82NzkyZjQ1MGZhYWM0ZTdlYjRhZjI0YjIxYjY1ZWU0NF9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>睪丸存活的判斷：<\/h3><h3>睪丸扭轉(zhuǎn)后如何判斷睪丸是否存活 ：與扭轉(zhuǎn)時間有關(guān)： <\/h3><h3>扭轉(zhuǎn)發(fā)生６小時內(nèi)手術(shù)，睪丸存活率１００％； <\/h3><h3>扭轉(zhuǎn)發(fā)生后６－１２小時手術(shù)，睪丸存活率７０％； <\/h3><h3>扭轉(zhuǎn)發(fā)生后１２－２４小時手術(shù)，睪丸存活率２０％； <\/h3><h3>睪丸扭轉(zhuǎn)發(fā)生２４小時以上手術(shù)，睪丸多無存活可能．<\/h3><h3>睪丸扭轉(zhuǎn)所致的睪丸缺血壞死，不僅與扭轉(zhuǎn)程度有關(guān)，還與扭轉(zhuǎn)持續(xù)的時間有關(guān)。持續(xù)扭轉(zhuǎn)90°、180°、360°和720°時發(fā)生睪丸壞死的時間分別為7d、3-4d、12-24h和2h。<\/h3><h3>一般睪丸扭轉(zhuǎn)在10h以內(nèi)復(fù)位者，睪丸可存活，無嚴重不良后果，24h內(nèi)復(fù)位者約半數(shù)可恢復(fù)睪丸功能，超過24h者多不可避免發(fā)生睪丸壞死、萎縮。當睪丸扭轉(zhuǎn).>360°，且>24h者最終均導(dǎo)致睪丸壞死。 <\/h3>"},{"text":"<h3>研究表明，睪丸缺血6h即對生精功能產(chǎn)生嚴重損害，而更嚴重的是，它還可以引起對側(cè)睪丸細胞凋亡，并誘導(dǎo)產(chǎn)生抗精子抗體，而使精子數(shù)量減少，精液質(zhì)量下降，影響生育能力，且影響程度與睪丸壞死情況，扭轉(zhuǎn)時間呈正相關(guān)。因此對生育力有要求者要放寬睪丸切除的適應(yīng)證。 <\/h3>"},{"img_height":480,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/6f66e661bec74d7d8e88b6dc81ddd601__jpg.heic","img_width":566,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi82ZjY2ZTY2MWJlYzc0ZDdkOGU4OGI2ZGM4MWRkZDYwMV9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"img_height":894,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/5d5aa8a331234a4f902ef426501b74a0__jpg.heic","img_width":1024,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi81ZDVhYThhMzMxMjM0YTRmOTAyZWY0MjY1MDFiNzRhMF9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"img_height":872,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/948f83066fb749049857a893071dee24__jpg.heic","img_width":656,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi85NDhmODMwNjZmYjc0OTA0OTg1N2E4OTMwNzFkZWUyNF9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"}]},"ext":{"id":52586610,"article_id":49422094,"ip":"","origin_status":0,"edit_from":0,"client_type":0,"password_v2":"","uv":1,"font_id":0,"title_style":"","rich_text_title":null,"gift_switch":1,"deleted_at":0,"recycle_expired_at":0,"share_with_nickname":0,"enable_watermark":0,"music_id":0,"music_source":-1,"_auto_update_time":"2026-03-11 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[{"text":"<h3>近日，連續(xù)兩例突然腹痛的患兒，因基層或非專業(yè)醫(yī)師缺乏對\"睪丸扭轉(zhuǎn)\"了解和認識，導(dǎo)致患兒不得不做一側(cè)睪丸切除手術(shù)。造成終身遺憾！<\/h3>"},{"text":"<h3>日常生活中，不少患者對睪丸扭轉(zhuǎn)麻痹大意，疼痛時一忍再忍，以致延誤了早期治療，個別人因此喪失生育能力，釀成終生不幸。因此，青春期及其前后的患者如突然出現(xiàn)陰囊腫脹、疼痛，尤其是青少年，應(yīng)考慮到睪丸扭轉(zhuǎn)的可能，要及時去醫(yī)院泌尿外科檢查診治。此外，如果不幸發(fā)生睪丸扭轉(zhuǎn)，治療后要請醫(yī)生做精液常規(guī)檢查，以了解病側(cè)睪丸及對側(cè)睪丸的功能，這一點對未婚男青年顯得更為重要。<\/h3>"},{"img_height":470,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/51d9f7cd24964310bcc37a6f201023c2__jpg.heic","img_width":474,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi81MWQ5ZjdjZDI0OTY0MzEwYmNjMzdhNmYyMDEwMjNjMl9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>什么是睪丸扭轉(zhuǎn)？臨床表現(xiàn)常見癥狀是什么？<\/h3><h3>睪丸通過睪丸系膜與陰囊相連，由睪丸系膜將睪丸固定于陰囊。有的胎兒在發(fā)育時會產(chǎn)生一側(cè)或兩側(cè)睪丸系膜過長，出生后，睪丸與精索的活動度就很大，如果突然遇上用力或猛烈震蕩等情況，睪丸與精索就會發(fā)生一定程度的扭轉(zhuǎn)，也叫精索扭轉(zhuǎn)。<\/h3><h3>臨床表現(xiàn)：<\/h3><h3>1.腹部突然出現(xiàn)劇痛。<\/h3><h3>2.睪丸出現(xiàn)劇痛。<\/h3><h3>3.發(fā)生扭轉(zhuǎn)的睪丸在陰囊內(nèi)的位置顯得較正常睪丸高一些。<\/h3><h3>4.患兒可能會出現(xiàn)惡心、嘔吐。<\/h3><h3>5.癥狀出現(xiàn)數(shù)小時后，陰囊會紅腫、觸痛。<\/h3>"},{"img_height":1100,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/b7bd9eef18fc4f81a0abbbc280b601a7__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi9iN2JkOWVlZjE4ZmM0ZjgxYTBhYmJiYzI4MGI2MDFhN19fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>診斷：<\/h3><h3>1.常見于青少年，而18歲以下青少年除了急性腮腺炎、睪丸炎以外發(fā)生附睪睪丸炎的機會較少。青少年陰囊急癥應(yīng)首先考慮睪丸扭轉(zhuǎn)。<\/h3><h3>2.很多患者為睡眠中或劇烈活動后發(fā)病，睪丸扭轉(zhuǎn)40%左右發(fā)生于安靜或睡眠中。可能于睡眠時迷走神經(jīng)興奮，提睪肌收縮頻率增加，睡眠中不斷改變姿勢或擠壓睪丸造成扭轉(zhuǎn)；<\/h3><h3>3.一般疼痛在前，漸進性睪丸或附睪腫大在后；<\/h3><h3>4.<72h患者多數(shù)無發(fā)熱；<\/h3><h3>5.既往有類似疼痛發(fā)作史，持續(xù)時間短，一旦扭轉(zhuǎn)復(fù)位后疼痛立即消失；<\/h3><h3>6.發(fā)病早期常因提睪肌痙攣而精索縮短，睪丸向上移位或呈橫位或附睪位置異常；<\/h3><h3>7.托起陰囊，疼痛不減輕反而加重<\/h3><h3>8.提睪肌反射消失：是診斷睪丸扭轉(zhuǎn)最敏感的指標，提睪反射存在可排除睪丸扭轉(zhuǎn)<\/h3><h3>9.彩色多普勒檢查CDFI檢查有特異性<\/h3>"},{"img_height":1600,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/66eb725b3f5a4840a47ff9f2d9f1e148__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi82NmViNzI1YjNmNWE0ODQwYTQ3ZmY5ZjJkOWYxZTE0OF9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>治療<\/h3><h3>復(fù)位越早越好，對睪丸扭轉(zhuǎn)的治療要爭分奪秒，一旦確診或高度懷疑本病時應(yīng)迅速果斷地實施探查術(shù)，以保留和挽救睪丸，保護生精功能。<\/h3>"},{"img_height":900,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/948a4930ffb544f2acab8d0cd37ef0ea__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi85NDhhNDkzMGZmYjU0NGYyYWNhYjhkMGNkMzdlZjBlYV9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>手法復(fù)位<\/h3><h3>有人認為，在積極術(shù)前準備的同時，可試行手法復(fù)位，更能快捷的解救缺血的睪丸，挽救睪丸功能，為手術(shù)復(fù)位贏得時間。但超過6h的扭轉(zhuǎn)由于睪丸附睪出現(xiàn)不同程度的腫大、淤血，精索扭轉(zhuǎn)處增粗、水腫，甚至發(fā)生粘連，故不宜手法復(fù)位。行手法復(fù)位時要準確判斷扭轉(zhuǎn)的方向和程度。否則會加重和延誤病情。一般左側(cè)睪丸多為逆時針方向扭轉(zhuǎn)，右側(cè)多為順時針方向扭轉(zhuǎn)。一旦復(fù)位方向正確，復(fù)位成功，能迅速恢復(fù)睪丸血運，患者局部疼痛可很快減輕或消失。不論復(fù)位成功與否，都應(yīng)立即施行手術(shù)復(fù)位或固定術(shù)。<\/h3>"},{"img_height":1328,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/7f47823c44024a73b7f599321c620fd6__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi83ZjQ3ODIzYzQ0MDI0YTczYjdmNTk5MzIxYzYyMGZkNl9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>手術(shù)治療：<\/h3><h3>1.睪丸固定：術(shù)中探查復(fù)位，如睪丸白膜無缺血性改變，切除部分鞘膜，將睪丸前、后、下各固定1針，精索與外周組織固定2針。<\/h3><h3>2.部分切除：對白膜呈紫斑點狀的，可試行切開白膜向睪丸門方向逐步剔除壞死組織，如遇到有新鮮出血即可留下殘留組織<\/h3><h3>3.行睪丸切除時在白膜內(nèi)切除壞死組織，保留白膜等殘留結(jié)構(gòu)，減輕患者的心理負擔。 <\/h3>"},{"img_height":622,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/fbb71a84f7704549bd0f5b5efad2478a__jpg.heic","img_width":1200,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi9mYmI3MWE4NGY3NzA0NTQ5YmQwZjViNWVmYWQyNDc4YV9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>遵循原則：<\/h3><h3>1.睪丸生機判斷不清時一律切除；<\/h3><h3>2.扭轉(zhuǎn)時間>24h者一律切除；<\/h3><h3>3.扭轉(zhuǎn)>360°、時間>12h或扭轉(zhuǎn)>720°、時間>6h者一律切除。<\/h3>"},{"img_height":458,"img_url":"https:\/\/ss-mpvolc.meipian.me\/users\/9709472\/6792f450faac4e7eb4af24b21b65ee44__jpg.heic","img_width":538,"watermark":"?meipian-watermark\/bucket\/ivwen\/key\/dXNlcnMvOTcwOTQ3Mi82NzkyZjQ1MGZhYWM0ZTdlYjRhZjI0YjIxYjY1ZWU0NF9fanBnLmhlaWM=\/nickname\/54mb5aSn5aSr\/userid\/OTcwOTQ3Mg==\/sign\/2ff8423c99ce7e1f8fe0955818840029"},{"text":"<h3>睪丸存活的判斷：<\/h3><h3>睪丸扭轉(zhuǎn)后如何判斷睪丸是否存活 ：與扭轉(zhuǎn)時間有關(guān)： <\/h3><h3>扭轉(zhuǎn)發(fā)生６小時內(nèi)手術(shù)，睪丸存活率１００％； <\/h3><h3>扭轉(zhuǎn)發(fā)生后６－１２小時手術(shù)，睪丸存活率７０％； <\/h3><h3>扭轉(zhuǎn)發(fā)生后１２－２４小時手術(shù)，睪丸存活率２０％； <\/h3><h3>睪丸扭轉(zhuǎn)發(fā)生２４小時以上手術(shù)，睪丸多無存活可能．<\/h3><h3>睪丸扭轉(zhuǎn)所致的睪丸缺血壞死，不僅與扭轉(zhuǎn)程度有關(guān)，還與扭轉(zhuǎn)持續(xù)的時間有關(guān)。持續(xù)扭轉(zhuǎn)90°、180°、360°和720°時發(fā)生睪丸壞死的時間分別為7d、3-4d、12-24h和2h。<\/h3><h3>一般睪丸扭轉(zhuǎn)在10h以內(nèi)復(fù)位者，睪丸可存活，無嚴重不良后果，24h內(nèi)復(fù)位者約半數(shù)可恢復(fù)睪丸功能，超過24h者多不可避免發(fā)生睪丸壞死、萎縮。當睪丸扭轉(zhuǎn).>360°，且>24h者最終均導(dǎo)致睪丸壞死。 <\/h3>"},{"text":"<h3>研究表明，睪丸缺血6h即對生精功能產(chǎn)生嚴重損害，而更嚴重的是，它還可以引起對側(cè)睪丸細胞凋亡，并誘導(dǎo)產(chǎn)生抗精子抗體，而使精子數(shù)量減少，精液質(zhì)量下降，影響生育能力，且影響程度與睪丸壞死情況，扭轉(zhuǎn)時間呈正相關(guān)。因此對生育力有要求者要放寬睪丸切除的適應(yīng)證。 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