تدبير حالات لوي (انفتال) الخصية في مشفى الأسد الجامعي في اللاذقية
Abstract
تمت دراسة 25 حالة لوي خصية في مشفى الأسد الجامعي في اللاذقية, وذلك خلال فترة 5 سنوات حيث كان متوسط العمر(18.56) سنة تم التشخيص اعتماداً على الأعراض والفحص السريري حيث وجد الألم الخصوي الحاد والمفاجىء في كل الحالات (%100) مع زيادة حجم نصف الصفن الموافق في(%96) من الحالات والتوضع العالي للخصية في(%92 ) مع جس كتلة الانفتال في(%80), وكان المنعكس المشمري غائباً في(%72) من الحالات.
تراوحت الفترة بين بدء الأعراض ومراجعة مشفانا من نصف ساعة إلى أسبوع حيث كان العامل الطبي هو السبب في التأخير في الفترات التي زادت عن 24 ساعة, وكان ذلك في 3 حالات(%12), وكان إهمال الأهل و المريض السبب في التأخير في الفترات بين 6 24 ساعة, وكان ذلك في 7 حالات(%28) أما المرضى الذين راجعوا في فترات أقل من 6 ساعات فكانوا 15 حالة(%60).
أجري الإيكو دوبلر لـ23 مريض (%92), وكان إيجابياً في (%95.7) (أي انعدام أو نقص في التروية).
تم إجراء العمل الجراحي لكل المرضى حيث تمت المحافظة على الخصية في 21 حالة(%84) واستئصال الخصية في 4 حالات (%16) تم تثبيت الخصية المقابلة في18 حالة (%72).
During 5 years, 25 cases of testis torsion had been studied in Al-Assad University Hospital in Lattakia of persons between 18 and 56 years old. Diagnosis was based on symptoms and clinical examination. Sudden acute testicular pain was found in all cases (100%); swelling in testis in (96%); upper located testis in (92%); torsion mass palpation in (80%); and cremasteric reaction in (72%).
Patients came to our hospital after a period between 0.5 hour to one week. Delay of more than 24 hours was because of a medical agent in 3 cases (12%); 6-24 hours of delay was because of parents' neglect and happened in 7 cases (28%). Patients who came to hospital within 6 hours were 15 cases (60%).
Echo- Doppler was performed on 23 patients (92%); it was positive in (95.7%). Surgery was performed on all patients. Testis remained intact in 21 cases (84%), and was removed in 4 cases (16%). Fixation of the testis was performed in 18 cases (72%).
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