... 睪丸固定術orchiopexy 避免之後再次發生扭轉, 手術中也可能發現仍有部分扭轉. ... successful manual detorsion because orchiopexy (securing the testicle to the ...急診小醫師https://dictionary.cambridge.org/zht/日誌相簿影音好友名片201712211357TESTICULARTORSION?外科_骨科睪丸扭轉需緊急手術解除扭轉,兩側都需處理(因睪丸引帶固定不良通常是雙側缺陷),扭轉超過六小時可能導致睪丸壞死.需手術切除.(fromuptodate). Surgery—Detorsionandfixationofboththeinvolvedtestisandthecontralateraluninvolvedtestisshouldbeperformedsinceinadequategubernacular引帶fixationisusuallyabilateraldefect.Extendedperiodsofischemia(>6hours)maycauseinfarctionofthetestiswithliquefaction液化requiringorchiectomy.21歲以上,睪丸能救回的機率41%,21歲以下,睪丸能救回的機率70%,成人精索扭轉的程度通常大於小孩. Theoutcomeofsurgerymaybeworseinadultsthaninchildren.Inoneretrospectivestudy,thetesticularsalvageratesofpatientsage<21yearsandage≥21yearswere70and41percent,respectively[10].Whilethetimetopresentationwasthemostimportantfactoraffectingthesalvagerate,adultmenalsohadagreaterdegreeofcordtwistingthantheyoungergroup,whichmaypartlyexplainthedifferenceinoutcomes.如果無法於兩小時內進行手術,可嘗試徒手扭轉復位,通常不給止痛藥,以免遮掩扭轉的症狀,徒手扭轉之後仍需手術,需以睪丸固定術orchiopexy避免之後再次發生扭轉,手術中也可能發現仍有部分扭轉. Manualdetorsion—Ifsurgeryisnotavailablewithintwohours,anattempttodetorsethetesticlemanuallyiswarranted(figure5).Observationalstudiesinchildrenhavesuggestedreliefofpainandimprovedtesticularsalvagewithmanualdetorsion(see"Causesofscrotalpaininchildrenandadolescents",sectionon'Manualdetorsion').Ingeneral,analgesicsarenotgivenbecauseofconcernofmaskingcontinuedtorsion.Surgicalexplorationisnecessaryevenaftersuccessfulmanualdetorsionbecauseorchiopexy(securingthetesticletothescrotalwall)shouldbeperformedtopreventrecurrence,andresidualtorsionmaybepresentthatcanbefurtherrelieved[22].一項回溯性研究發現約有1/3病患是往外扭轉,其他是往內扭轉,扭轉角度180-720度, Theclassicteachingisthatthetestisusuallyrotatesmediallyduringtorsionandcanbedetorsedbyrotatingitoutwardtowardthethigh.However,inaretrospectiveanalysisof200consecutivemalesage18monthsto20yearswhounderwentsurgicalexplorationfortesticulartorsion,lateralrotationwaspresentinone-thirdofcases[22].Thedegreeoftwisti