摘要
目的探讨精囊镜探查技术在慢性精囊炎诊治中的应用价值。方法选择本院2013年12月至2015年12月就诊的58例慢性精囊炎患者,术前均行经直肠超声,精囊MRI或CT扫描等检查排除精囊肿瘤、结核、前列腺占位,经至少4周的抗感染治疗后症状仍不能好转的患者行精囊镜探查手术,对发现的结石予以钬激光碎石,陈旧性血块予以冲洗并以稀碘伏液体冲洗精囊;术后继续抗感染治疗。结果 58例患者均顺利完成手术,手术时间25~100 min,平均(53.4±19.3)min,术后均未出现直肠损伤、尿失禁等并发症;术后随访54例患者血精症状消失或明显好转,合并症状也明显改善或彻底治愈。对于不同年龄段患者血精及射精痛症状缓解率无明显差异,而不同发病时间的血精症状缓解率有显著性差异。结论精囊镜探查可用于治疗保守治疗效果欠佳的慢性精囊炎患者,手术安全性高,并发症较少,治疗效果满意。
Objective To explore the safety and effectiveness of seminal vesiculoscopy in the diagnosis and treatment of chronic vesiculitis. Methods We retrospectively analyzed the clinical data of 58 patients with chronic vesiculitis treated with seminal vesiculoscopy during Dec. 2013 and Dec. 2015 in our hospital. The patients underwent transrectal ultrasonography, pelvis CT or MRI scan before the operation to exclude tumor, tuberculosis of seminal vesicle, and prostate tumor. After antibiotic treatment for 4 weeks, patients with symptoms unimproved received transurethral seminal vesiculoscopy. Stones were crushed with holmium laser lithotripsy, the old blood clots were washed, and the seminal vesicle was rinsed with dilute iodine water. After operation, patients received anti-infection treatment. Results All operations were successful. The operation time was 25-100 min （mean 53.4＋_ 19.3 min）. No serious complications such as rectal injury or urinary incontinence occurred. During the follow-up, hematospermia disappeared in 54 cases, and accompanied symptoms were significantly improved or completely cured. There was significant difference in the remission rate of hematospermia for patients with different time of onset. Conclusion Seminal vesiculoscopy can be used to for patients with chronic vesiculitis whose are not responsive to conservative treatment. It is safe and effective, causing few complications.
出处
《国外医学（医学地理分册）》
CAS
2017年第1期52-56,共5页
Foreign Medical Sciences：Section of Medgeography
关键词
精囊镜探查
慢性精囊炎
血精
seminal vesiculoscopy
chronic vesiculitis
hematospermia
