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目的探讨腹壁下动静脉(A-V)血管吻合在小儿高位隐睾手术复位中应用。方法利用腹壁下A-V血管的特殊解剖结构,选用血管的终末枝与精索A-V吻合,延长精索血管,改善血流的方式对19例小儿难以复位隐睾的手术治疗。结果术后16例精索睾丸供血良好,彩超和多普勒检查精索血管血流通畅搏动有力,1年后睾丸体积增大,触摸弹性佳,3例睾丸质略硬,附睾触摸呈圆钝感,精索血流呈断断续续状态,睾酮放射免疫测定(TRIA)均值升高。结论利用腹壁下A-V与精索A-V吻合治疗小儿高位隐睾,延长了血管的长度,改善了精索血管张力和睾丸血流,防止因精索血管短,睾丸因供血不足而出现萎缩,手术使睾丸一次性复位,避免了二期手术和睾丸切除。此方法对小儿高位隐睾睾丸的保留有一定的临床价值。
Objective To investigate the application of inferior abdominal arteriovenous (A-V) vascular anastomosis in the reduction of pediatric high cryptorchidism. Methods The special anatomical structure of A-V blood vessels under the abdominal wall was used to select the surgical treatment of 19 cases of children with difficult to reset cryptorchidism by means of matching the terminal branch of blood vessels with A-V of spermatic cord, prolonging spermatic vessels and improving blood flow. Results After the operation, 16 cases of spermatic cord testis were in good condition. Color doppler and Doppler examination showed that the blood flow of the spermatic cord was smooth and pulsatile. After 1 year, the testicular volume increased, the elasticity of touch was good, and the testicular quality was slightly stiff in 3 cases. Sense, spermatic blood flow was intermittent, testosterone radioimmunoassay (TRIA) mean value increased. Conclusions The use of AV abdominal anastomosis with sonic anastomosis AV treatment of children with high cryptorchidism, extending the length of the blood vessels, improving spermatic vascular tension and testicular blood flow, to prevent spermatic cord blood short, testes due to lack of blood supply and atrophy, surgery Testicular one-time reduction, to avoid the two surgical and orchiectomy. This method of pediatric high cryptorchid testis retention has some clinical value.