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目的探讨超声在小儿睾丸异位的应用价值。方法对我院经手术确诊为睾丸异位的50例患儿,年龄为15d~12岁,回顾分析其临床表现、声像图及手术病理结果。结果 50例患儿中左侧睾丸异位26例、右侧睾丸异位23例、双侧睾丸异位1例。(1)32例睾丸异位至同侧,包括会阴部浅筋膜层18例、前腹壁皮下浅筋膜层7例、腹股沟管浅袋3例、大腿内侧根部3例、阴茎根部1例。(2)18例睾丸异位至对侧,包括对侧阴囊内9例、对侧腹股沟管内5例、对侧盆腔内4例。(3)睾丸大小:异位睾丸的长、宽及横径均小于非异位侧睾丸,差异具有统计学意义(P均<0.05)。(4)合并畸形:异位睾丸合并对侧睾丸下降不全7例、腹股沟疝7例、鞘膜积液10例、合并睾丸扭转1例、合并米勒管永存综合征2例。(5)手术及随访结果:50例患儿均行睾丸固定术。随访时间2个月~5年,睾丸未发生明显萎缩,未发生继发性睾丸肿瘤。结论超声可以准确显示睾丸的位置及其发育,评价治疗结局及预后,是小儿睾丸异位的首选影像学方法。
Objective To investigate the value of ultrasound in pediatric testicular dysplasia. Methods Fifty children diagnosed as ectopic by surgery were aged 15 days to 12 years. The clinical manifestations, sonography and pathology were retrospectively analyzed. Results In 50 children, there were 26 cases of left testicular ectopic, 23 cases of right testicular ectopic and 1 case of bilateral testicular ectopic. (1) 32 cases of testicular ectopic to the same side, including the perineal superficial fascia in 18 cases, the anterior abdominal wall of the superficial fascia in 7 cases, 3 cases of inguinal tube sphincter, thigh medial root in 3 cases, penile root in 1 case. (2) Eighteen cases of testis were ectopic to contralateral, including 9 cases in contralateral scrotum, 5 cases in contralateral inguinal canal and 4 cases in contralateral pelvic cavity. (3) Testicular size: The length, width and transverse diameter of ectopic testes were all less than that of non-ectopic testes, with statistical significance (all P <0.05). (4) with deformity: ectopic testes with contralateral testicular descent in 7 cases, 7 cases of inguinal hernia, hydrocele in 10 cases, combined testicular torsion in 1 case, combined with Miller’s persistent syndrome in 2 cases. (5) Surgical and follow-up results: 50 cases of children underwent testicular fixation. Follow-up time of 2 months to 5 years, no significant testicular atrophy, no secondary testicular tumor. Conclusion Ultrasound can accurately display the location of testis and its development, evaluation of the outcome and prognosis of treatment, is the preferred imaging method of pediatric testicular ectopic.