经尿道精囊镜诊治顽固性血精及精囊结石的临床研究

Transurethral seminal vesiculoscopy for recurrent hemospermia and seminal vesicle stone clinical research

目的 探讨经尿道精囊镜诊治顽固性血精及精囊结石手术治疗方法和临床应用价值。方法 选择2013年1月-2015年6月在我科就诊的36例顽固性精囊疾病患者,按随机法分为观察组和对照组,各18例。观察组采用经尿道精囊镜治疗顽固性血精的方法,对照组采用超声引导下精囊穿刺置管治疗的方法,观察两组治疗效果。结果 观察组中15例行双侧精囊清洗,3例无法进入另一侧精囊而仅行单侧精囊清洗,其中12例精囊炎,6例合并精囊结石,观察组平均手术时间（37.5±3.3）min,术中出血量（35.9±2.6）ml,手术时间、术中出血量均明显低于对照组,差异有统计学意义（P〈0.05）;观察组治愈率94.4%,复发率为5.6%,对照组治愈率77.8%,复发率为27.8%,观察组均优于对照组,差异有统计学意义（P〈0.05）;观察组精子密度和精子存活率指标均高于对照组,差异有统计学意义（P〈0.05）;观察组未出现并发症,对照组并发症发生率为22.2%,观察组优于对照组,差异有统计学意义（P〈0.05）。结论 经尿道精囊镜诊治顽固性血精治愈率高、创伤小、并发症少,可降低血精复发率,疗效确切。

Objective To explore the diagnosis and treatment of transurethral seminal vesiculoscopy for recurrent hemospermia and seminal vesicle stone surgical treatment method and clinical application value. Methods From January 2013 to June 2015,36 patients with intractable seminal vesicle disease who were treated in our department were randomly divided into observation group and control group,18 cases in each group.according to the random number table method.Observation group was treated with transurethral seminal mirror treatment of persistent hematospermia.Observation group by ultrasound guided seminal vesicle PUncture treatment,the therapeutic effect in the two groups were observed. Results In the observation group,15 patients were treated with seminal vesicle cleaning, and 3 patients had no access to the other side of the seminal vesicle and only one side of the seminal vesicle was washed,including 12 cases of seminal vesicle,6 cases with seminal vesicle stones.The average operation time （37.5±3.3） min,the amount of bleeding （35.9±2.6） ml,the operation time and blood loss was significantly lower than that of the control group respectively （P〈 0.05）.The cure rate was 94.4%,the recurrence rate was 5.6%,the cure rate was 77.8%,the recurrence rate was 27.8%, the observation group was better than that of the control group,with significant difference （P〈0.05）,and the sperm survival rate of the observation group was higher than that of the control group, with significant difference （P〈0.05）.The observation group did not appear the symptoms,the control group,the incidence of complications was 22.2%,the observation group was better than that of the control group,with significant difference （P〈0.05）. Conclusion Transurethral seminal vesicle microscopic diagnosis and treatment of persistent hematospermia cure rate is high,small trauma,fewer complications,reduce the rate of hematospermia recurrence,the curative effect is accurate. [Key words] Seminal vesicle;Obstinate hemospermia;Seminal vesicle stone;Hemospermia