Article(id=1292130371265655163, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130254689165893, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.05.018, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750348800000, receivedDateStr=2025-06-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785997487131, onlineDateStr=2026-08-06, pubDate=1773676800000, pubDateStr=2026-03-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785997487131, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785997487131, creator=13701087609, updateTime=1785997487131, updator=13701087609, issue=Issue{id=1292130254689165893, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='5', pageStart='601', pageEnd='750', issueExtLink='null', onlineDate='null', pubDate='1773676800000', pubDateStr='2026-03-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785997459337, creator='13701087609', updateTime=1786014469153, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292201599108141219, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130254689165893, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292201599108141220, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130254689165893, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=715, endPage=719, ext={EN=ArticleExt(id=1292130372876267900, articleId=1292130371265655163, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of application on the optimization of clinical procedures and the combined application of acetylcysteine on the diagnosis and treatment of testicular torsion, columnId=1291704944038536012, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Rational Use of Drugs, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of optimized clinical procedures combined with N-acetylcysteine (NAC) tablets in the diagnosis and treatment of testicular torsion.
Methods Patients diagnosed with testicular torsion in our hospital from January 2020 to January 2022 were enrolled as control group and received routine diagnosis and treatment. Patients treated from January 2023 to January 2024 who underwent optimized clinical procedures combined with postoperative oral NAC tablets were enrolled as treatment group. The treatment group implemented optimized clinical procedures (including health education, fast track pathway, simplified evaluation and surgical preparation, etc.) and started oral NAC tablets on the second day after surgery (200 mg each time, 3 times daily, for 1 consecutive week). The two groups were compared in terms of time from symptom onset to hospital arrival (T1), time from hospital arrival to surgery start (T2), total ischemia time (T3), orchiectomy rate and testicular atrophy rate at 6 months postoperatively.
Results T1 in treatment group and control group were 8.00 (5.00, 12.00) and 62.00 (51.00, 72.00) min, respectively; T2 were 52.00 (48.00, 57.00) and 109.00 (85.00, 135.50) min, respectively; and T3 were 60.00 (56.00, 64.00) and 171.50 (149.00, 199.00) min, respectively. The differences in the above indicators between the two groups were statistically significant (all P<0.001). The orchiectomy rate was 65.00% in treatment group and 82.00% in control group, with a statistically significant difference (P<0.001, RR=0.78, 95%CI: 0.66-0.91). At 6 months postoperatively, among patients who underwent testicular salvage, the testicular atrophy rate was 11.43% in treatment group and 33.33% in control group, with a statistically significant difference (P<0.05, RR=0.30, 95%CI: 0.10-0.94). Multivariate logistic regression analysis showed that the combined intervention was an independent protective factor for reducing orchiectomy rate (P=0.001, OR=0.31, 95%CI: 0.15-0.64). In terms of safety, only 3 (3.00%) patients in treatment group reported mild nausea, with no serious adverse drug reactions; no related adverse reactions occurred in control group.
Conclusion The application of optimized clinical procedures combined with N-acetylcysteine tablets shows significant clinical benefits in the treatment of testicular torsion, helping to shorten treatment time, reduce testicular injury, improve testicular survival rate, and exhibits a favorable safety profile.
, authors=Xiao-jian DIAO, Zhen-hui PAN, Wei-dong ZHOU, authorsList=Xiao-jian DIAO, Zhen-hui PAN, Wei-dong ZHOU, authorCompany=null, correspAuthors=Wei-dong ZHOU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1292130373161480573, articleId=1292130371265655163, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=优化就诊流程联合应用乙酰半胱氨酸在睾丸扭转诊疗中的临床研究, columnId=1291704944210502478, journalTitle=中国临床药理学杂志, columnName=合理用药, runingTitle=null, highlight=null, articleAbstract=
目的 观察优化就诊流程联合N-乙酰半胱氨酸（NAC）片在睾丸扭转诊疗中的临床疗效和安全性。
方法 2020年1月至2022年1月以本院确诊的睾丸扭转患者纳入为对照组，接受常规诊疗；2023年1月至2024年1月以采取优化就诊流程并联合术后口服NAC片的患者纳入为试验组，试验组实施优化就诊流程（包括健康教育、快速通道、简化评估与手术准备等），并于术后第2天开始口服NAC片（每次200 mg，每日3次，连续给药1周）。比较2组患者的就诊时间（T1，从症状出现到就诊）、开始手术时间（T2，从就诊到手术开始）、总缺血时间（T3）、睾丸切除率及术后6个月睾丸萎缩率的差异。
结果 试验组与对照组的T1时间分别为8.00（5.00，12.00）和62.00（51.00，72.00）min，T2时间分别为52.00（48.00，57.00）和109.00（85.00，135.50）min，T3时间分别为60.00（56.00，64.00）和171.50（149.00，199.00）min，试验组的上述指标与对照组比较，在统计学上差异均有统计学意义（均P<0.001）。试验组的睾丸切除率为65.00%，对照组为82.00%，在统计学上差异有统计学意义（P<0.001，RR=0.78，95%CI：0.66~0.91）。术后6个月，在保留睾丸的患者中，试验组的睾丸萎缩率为11.43%，对照组为33.33%，在统计学上差异有统计学意义（P<0.05，RR=0.30，95%CI：0.10~0.94）。多因素Logistic回归分析显示，联合干预是降低睾丸切除率的独立保护因素（OR=0.31，95%CI：0.15-0.64，P=0.001）。安全性方面，试验组仅3例（3.00%）出现轻度恶心，无严重药物不良反应；对照组未使用NAC，无相关药物不良反应。
结论 优化就诊流程联合N-乙酰半胱氨酸片的应用在睾丸扭转治疗中显示出显著的临床效益，有助于缩短治疗时间，减少睾丸损伤，提高睾丸存活率，且安全性良好。
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刁晓剑（1986-），男，主治医师，主要从事泌尿外科相关的临床工作和研究
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