【摘要翻译】反对隐睾激素治疗的结构证据：异常的引带附着处
发布于 2004-06-11 · 浏览 922 · IP 陕西陕西
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[文题]STRUCTURAL EVIDENCE AGAINST HORMONAL THERAPY FOR CRYPTORCHID TESTIS: ABNORMAL GUBERNACULAR ATTACHMENT.
反对隐睾激素治疗的结构证据：异常的引带附着处
[来源]Journal of Urology.
[年、卷、期、页]2004. 171(6, Part 1 of 2):2427-2429, June 2004.
[作者]HAN, WOONG KYU; KIM, JANG HWAN; HONG, CHANG HEE; HAN, SANG WON
[原文摘要]
Purpose: Various factors are involved in testicular descent, and no single factor is elucidated as the cause of cryptorchidism. We prospectively observed the locations of gubernacular attachments in the cryptorchid testis.
Materials and Methods: From April 1996 to June 2002, 639 boys underwent surgical correction of cryptorchid testis. Those with complete records of testicular locations and gubernacular attachments were analyzed.
Results: A total of 639 boys underwent 732 surgical corrections of inguinal testis (425, 58%), high scrotal testis (165, 23%) and impalpable abdominal testis (142, 19%). Impalpable abdominal testes had gubernacular attachment to either the lateral or upper scrotum in 36 cases (25%) or around the inguinal ring in 83 (58%). The gubernaculum was attached to the bottom of the scrotum in 21 inguinal testes (5%), to the lateral or upper scrotum in 132 (31%) or around the inguinal ring in 268 (63%). In cases of high scrotal testis the gubernaculum was attached usually to the bottom of the scrotum (28, 17%), to the lateral or upper scrotum (109, 66%) or around the inguinal ring (26, 16%).
Conclusions: The locations of distal gubernacular attachments in the cryptorchid testis were usually abnormal (93%). In these cases the possible testicular descent induced by hormonal therapy may either be insufficient or unable to prevent future ascent. Thus, early surgical correction rather than hormonal therapy is warranted in boys with cryptorchid testis.
[中文译文]
目的：睾丸下降过程中牵涉多种因素，并无单一因素可以说明隐睾的原因。我们回顾了所观察到的隐睾睾丸的睾丸引带附着的位置。
材料与方法：1996年4月至2002年6月，639例患者接受隐睾矫治手术。分析其睾丸与睾丸引带附着位置的完整记录。
结果：共639例患者接受732次手术，包括腹股沟睾丸（425，58%），阴囊上部睾丸（165，23%）和不可触及的腹腔内睾丸（142，19%）。不可触及的腹腔内睾丸其引带附着处位于阴囊上部或者侧面者36例（25%），腹股沟环周围者83例（58%）。腹股沟睾丸其引带附着于阴囊底部者21例（5%），阴囊上部或侧面者132例（31%），腹股沟环周围者268例（63%）。阴囊上部睾丸其引带附着于阴囊底部者28例（17%），阴囊上部或侧面者109例（66%），腹股沟环周围者26例（16%）。
结论：隐睾患者睾丸引带的附着处通常是异常的（93%）。这些患者应用激素治疗而使睾丸下降是不够的或者难免再次上升。因此，对于隐睾患者应当早期手术矫治而不是激素治疗。
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[个人评论]经典教科书上一直将激素治疗作为一线的治疗方法，一般于10月龄开始。但据我临床观察，往往难以奏效。手术中发现引带附着的异常也好象没有这么高的比例。不过临床上的确是“留心处处皆学问”呀。
反对隐睾激素治疗的结构证据：异常的引带附着处
[来源]Journal of Urology.
[年、卷、期、页]2004. 171(6, Part 1 of 2):2427-2429, June 2004.
[作者]HAN, WOONG KYU; KIM, JANG HWAN; HONG, CHANG HEE; HAN, SANG WON
[原文摘要]
Purpose: Various factors are involved in testicular descent, and no single factor is elucidated as the cause of cryptorchidism. We prospectively observed the locations of gubernacular attachments in the cryptorchid testis.
Materials and Methods: From April 1996 to June 2002, 639 boys underwent surgical correction of cryptorchid testis. Those with complete records of testicular locations and gubernacular attachments were analyzed.
Results: A total of 639 boys underwent 732 surgical corrections of inguinal testis (425, 58%), high scrotal testis (165, 23%) and impalpable abdominal testis (142, 19%). Impalpable abdominal testes had gubernacular attachment to either the lateral or upper scrotum in 36 cases (25%) or around the inguinal ring in 83 (58%). The gubernaculum was attached to the bottom of the scrotum in 21 inguinal testes (5%), to the lateral or upper scrotum in 132 (31%) or around the inguinal ring in 268 (63%). In cases of high scrotal testis the gubernaculum was attached usually to the bottom of the scrotum (28, 17%), to the lateral or upper scrotum (109, 66%) or around the inguinal ring (26, 16%).
Conclusions: The locations of distal gubernacular attachments in the cryptorchid testis were usually abnormal (93%). In these cases the possible testicular descent induced by hormonal therapy may either be insufficient or unable to prevent future ascent. Thus, early surgical correction rather than hormonal therapy is warranted in boys with cryptorchid testis.
[中文译文]
目的：睾丸下降过程中牵涉多种因素，并无单一因素可以说明隐睾的原因。我们回顾了所观察到的隐睾睾丸的睾丸引带附着的位置。
材料与方法：1996年4月至2002年6月，639例患者接受隐睾矫治手术。分析其睾丸与睾丸引带附着位置的完整记录。
结果：共639例患者接受732次手术，包括腹股沟睾丸（425，58%），阴囊上部睾丸（165，23%）和不可触及的腹腔内睾丸（142，19%）。不可触及的腹腔内睾丸其引带附着处位于阴囊上部或者侧面者36例（25%），腹股沟环周围者83例（58%）。腹股沟睾丸其引带附着于阴囊底部者21例（5%），阴囊上部或侧面者132例（31%），腹股沟环周围者268例（63%）。阴囊上部睾丸其引带附着于阴囊底部者28例（17%），阴囊上部或侧面者109例（66%），腹股沟环周围者26例（16%）。
结论：隐睾患者睾丸引带的附着处通常是异常的（93%）。这些患者应用激素治疗而使睾丸下降是不够的或者难免再次上升。因此，对于隐睾患者应当早期手术矫治而不是激素治疗。
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[个人评论]经典教科书上一直将激素治疗作为一线的治疗方法，一般于10月龄开始。但据我临床观察，往往难以奏效。手术中发现引带附着的异常也好象没有这么高的比例。不过临床上的确是“留心处处皆学问”呀。
最后编辑于 2004-06-20 · 浏览 922
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