تدبير الخصى المختفية خبرة مشفى الأسد الجامعي بجامعة تشرين خلال ثلاث سنوات (2005-2008)
Abstract
تكون الخصية مختفية عندما تتوقف عن نزولها في أية نقطة من الطريق الطبيعي لنزولها بين جوف البطن والصفن, وتحدث عادةً عند الخُدَّج, وقد تمّ إجراء دراسة إحصائية تحليلية استرجاعية لأضابير مرضى الاختفاء الخصوي في مشفى الأسد الجامعي بجامعة تشرين وذلك خلال 3 سنوات (2005-2008) إذ بلغ عدد المرضى
59 مريضاً تراوحت أعمارهم بين 5 شهور و14 سنة (وسطياً 6.5 سنة), وكان الاختفاء الخصوي أحادي الجانب بنسبة 76.27% وثنائي الجانب بنسبة 23.73%, وكانت الخصية غير مجسوسة في 16.94% وداخل القناة الإربية في 54.23%, ووجدت تشوهات خلقية مرافقة منها المبال التحتاني وذلك بنسبة 5.08%, أما الفتوق الإربية الوصفية (أو رتج بشكل كيس الفتق) فقد وجدت بنسبة عالية (55.93%), وبالنسبة للتصوير بالأمواج فوق الصوتية فهو من الفحوص المتممة الأساسية, بينما يعد تنظير البطن من الفحوص المتممة الواعدة. وقد اكتشف حالة الاختفاء الخصوي طبيب الأطفال الفاحص للمولود الجديد في خلال الساعات القليلة التي تلت ولادته وذلك بنسبة 83,05%, وقد خضعت كل الحالات للتداخل الجراحي ولم تفد المعالجة بالـβ.H.C.G (عالمياً تبلغ نسبة الاستجابة لهذه المعالجة 10-15%). وكنتيجة لهذه الدراسة يُفضَّل إجراء التداخل الجراحي المبكر بين 12 و18 شهراً
(قبل السنة الثانية).
Cryptorchidism is the failure of testicle to show up in the scrotum during its normal descent, especially in pre-mature cases. An analytical retrospective study has been done for 3 years (2005-2008) at ALASSAD University Hospital, Lattakia, Syria. There were 59 cases; the variation of their age was between 5 months and 14 years (mean age: 6.5 years). Cryptorchidism was unilateral in 76.27% and bilateral in 23.73%; it was nonpalpable in 16.94%, intra-canalicular in 54.23%. Congenital malformations were observed, especially hypospadias (5.08%), inguinal hernias (55.93%). Ultrasonography will be an important complementary exam. During the examination of newborns by paediatricians, cryptorchidism was discovered in 83.05%. All cases were operated on; no benefits were obtained from medical treatment by β.H.C.G (response rates in these cases were between 10 and 15%, according to international studies). In conclusion, it is recommended that patients undergo operation between 12 and 18 months (before the 2nd year).
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