精索静脉血栓2例报道并文献复习
Spermatic vein thrombosis:a report of two cases and literature review
张忠云 1戴文斌 1黄燕平 2柴启亮 3汪东亚 1张正望 1孙忠全 1钱伟庆1
作者信息
- 1. 复旦大学附属华东医院泌尿外科,上海200040
- 2. 上海交通大学医学院附属仁济医院泌尿男科,上海200001
- 3. 复旦大学附属华东医院超声科,上海200040
- 折叠
摘要
目的 探讨精索静脉血栓的临床特点,提高诊治水平.方法 回顾精索静脉血栓病例2例,复习文献,总结诊疗要点.结果 报道2例精索静脉血栓病例.男性,23及37岁,因左侧阴囊疼痛急诊来院,体检:双侧睾丸附睾无肿大压痛.急诊超声睾丸附睾无肿大,血流正常.急诊予抗菌治疗,无好转.2～3日后门诊,精索静脉超声:左侧精索静脉曲张伴血栓形成.予保守治疗:非甾体抗炎药、胰激肽原酶及迈之灵口服.2周后症状缓解,2～3个月后超声示血栓消失.结论 精索静脉血栓罕见,临床表现为急性阴囊疼痛(左侧居多),体检睾丸附睾无肿大压痛,有时可扪及阴囊内条索样物,阴囊/精索静脉超声为诊断标准,首选保守治疗,如保守治疗7～10天效果不佳,应手术探查、切除静脉血栓.
Abstract
Objective To discuss and summarize clinical features of spermatic vein thrombosis for improving the level of diagnosis and treatment.Methods Clinical data of two cases of spermatic vein thrombosis,diagnosed and treated in our hospital recently,were summarized and analyzed combining with the related literature review for obtaining the main points of diagnosis and treatment.Results Two patients with of spermatic vein thrombosis,aged 23 and 37 years,came to the emergency of our hospital for left scrotal acute pain.Physical examination showed no swelling or tenderness in both testicles and epididymis.One patient had palpable cord-like material above the left testicle,with mild tenderness.The other patient had no abnormalities in the scrotum.Emergency ultrasound showed no swelling of the epididymis and normal testicular blood flow.The patients received antibacterial treatment,but no significant improvement was found.Two or three days later,the patients were diagnosed as left varicocele with thrombosis using ultrasound examination.Serum coagulation indexes were all normal.The patients received conservative treatment including NSAIDs,pancreatic kininogenase enteric-coated tablets and aescuven forte.After 2 weeks,their symptoms were basically improved.After 2-3 months,ultrasound examination revealed the disappearance of spermatic vein thrombosis.Conclusion Spermatic vein thrombosis is rare with clinical manifestations of acute scrotal pain ( mostly on the left side) .However,during physical examination,there is no obvious swelling or tenderness of the testis or epididymis,and sometimes a cord-like substance can be palpated within the scrotum.Ultrasound of the scrotum/spermatic vein is the diagnostic standard,and conservative treatment is the first choice.If conservative treatment is not effective for 7-10 days,surgical exploration and removal of the thrombotic vein should be performed.
关键词
精索静脉曲张/静脉血栓形成/病例报告Key words
varicocele/venous thrombosis/case reports引用本文复制引用
出版年
2024
NETL
NSTL
万方数据