【摘要】：目的:探討彩色多普勒對(duì)生殖器外傷的診斷,治療預(yù)后評(píng)價(jià)情況。方法:對(duì)我院于2009年6月--2012年12月60例生殖器外傷臨床資料進(jìn)行回顧性分析。本組60例中,其中睪丸外傷20例,睪丸破裂型3例,睪丸血腫型4例,睪丸挫傷型8例,睪丸炎型3例,睪丸扭轉(zhuǎn)2例。女性生殖器外傷40例,其中合并宮外孕破裂20例,合并黃體破裂15例,合并卵巢囊腫扭轉(zhuǎn)5例。結(jié)果本組60例經(jīng)二維超聲和彩色多普勒檢查患者中,隨訪時(shí)間1天--30天,平均7天。其中睪丸破裂及睪丸扭轉(zhuǎn)均手術(shù)治療;睪丸血腫,睪丸挫傷,睪丸炎型保守治療;女性生殖器外傷,其中宮外孕破裂14例,8例黃體破裂及3例卵巢囊腫扭轉(zhuǎn)均手術(shù)治療,6例宮外孕,7例黃體破裂保守治療。結(jié)論彩色多普勒是生殖器外傷重要的診斷方法,超聲造影有助于治療后評(píng)價(jià)療效;PW示峰值血流速度(Vmax),阻力指數(shù)(RI)對(duì)生殖器外傷的診斷價(jià)值及預(yù)后評(píng)價(jià),血、尿HCG檢查是區(qū)別宮外孕和黃體破裂重要指標(biāo);大于1/3睪丸破裂及睪丸扭轉(zhuǎn),實(shí)質(zhì)內(nèi)未探及血流信號(hào)或較健側(cè)明顯減少,必須手術(shù)治療;小于1/3睪丸破裂、睪丸挫傷,睪丸血腫、睪丸炎均可保守治療,但是當(dāng)病情出現(xiàn)進(jìn)一步加重時(shí)要及時(shí)手術(shù)。生殖器外傷合并卵巢囊腫扭轉(zhuǎn),其內(nèi)未探及血流信號(hào)或血流阻力指數(shù)非常高時(shí)須手術(shù)治療,合并宮外孕及黃體破裂時(shí),出血量不多時(shí)可保守治療,出血量非常多時(shí)必須手術(shù)。
[Abstract]:Objective: to evaluate the diagnosis and prognosis of genital trauma by color Doppler. Methods: the clinical data of 60 cases of genital trauma in our hospital from June 2009 to December 2012 were analyzed retrospectively. Among the 60 cases, there were 20 cases of testicular trauma, 3 cases of testicular rupture, 4 cases of testicular hematoma, 8 cases of testicular contusion, 3 cases of testicular inflammation and 2 cases of testicular torsion. There were 40 cases of female genital trauma, including 20 cases with extrauterine pregnancy rupture, 15 cases with corpus luteum rupture and 5 cases with ovarian cyst torsion. Results the follow-up time ranged from 1 day to 30 days (mean 7 days) in 60 patients who were examined by two dimensional ultrasound and color Doppler. Among them testicular rupture and testicular torsion were treated surgically, testicular hematoma, testicular contusion, testicular inflammation type conservative treatment; There were 14 cases of extrauterine pregnancy rupture, 8 cases of corpus luteum rupture and 3 cases of ovarian cyst torsion, 6 cases of ectopic pregnancy and 7 cases of conservative treatment. Conclusion Color Doppler is an important diagnostic method for genital trauma. Contrast-enhanced ultrasound is helpful to evaluate the curative effect after treatment. The value of PW peak flow velocity (Vmax), resistance index (RI) in diagnosis and prognosis of genital trauma was evaluated. HCG examination in blood and urine was an important index to distinguish ectopic pregnancy and corpus luteum rupture. More than 1 / 3 testicular rupture and testicular torsion, the blood flow signal was not detected in the parenchyma or decreased significantly compared with the healthy side, which must be treated surgically. Testicular rupture, testicular contusion, testicular hematoma and orchitis can be treated conservatively. The genital trauma complicated with ovarian cyst torsion should be treated surgically when the blood flow signal is not detected or the resistance index of blood flow is very high. In the case of extrauterine pregnancy and rupture of the corpus luteum, it can be treated conservatively when the amount of bleeding is not much, and the operation must be done when the volume of bleeding is very large.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1;R699

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