СИНДРОМ ОТЁЧНОЙ МОШОНКИ У ДЕТЕЙ: СОВРЕМЕННЫЕ ПОДХОДЫ К ДИАГНОСТИКЕ И ЛЕЧЕБНОЙ ТАКТИКЕ (ОБЗОР ЛИТЕРАТУРЫ)
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Аннотация:
Синдром отёчной мошонки у детей объединяет ряд острых состояний, требующих неотложной дифференциальной диагностики. Ведущими нозологическими формами являются перекрут яичка, перекрут гидатиды Морганьи и орхоэпидидимит. Перекрут яичка представляет наибольшую клиническую опасность: необратимые ишемические изменения паренхимы развиваются уже через 6 часов от начала заболевания, что диктует необходимость экстренного хирургического вмешательства. Клиническая диагностика основывается на анализе симптомокомплекса с применением валидированных шкал, в первую очередь TWIST. Ультразвуковое исследование с цветным допплеровским картированием является методом инструментальной верификации первого выбора, однако не может служить основанием для отказа от операции при высоком клиническом подозрении. Стандартом хирургического лечения остаётся деторсия с орхиопексией, включая профилактическую фиксацию контралатерального яичка. Совершенствование образовательных программ для населения и врачей первичного звена является ключевым условием снижения частоты органоуносящих операций
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