经前列腺小囊颈口外入路治疗精囊腺炎的疗效分析

Analysis of the curative effect of seminal vesicle endoscopy through the paracervical approach of the prostatic capsule

目的探讨经前列腺小囊颈口外入路治疗精囊腺炎的疗效。方法回顾性分析2020年4月至2021年9月在本院采用钬激光辅助下经前列腺小囊颈口外入路治疗的160例精囊腺炎患者的临床资料(经前列腺小囊颈口外入路组, 经前列腺小囊颈口外5、7点处进境), 另选取2018年1月至2020年4月在本院采用钬激光辅助下经前列腺小囊内破壁入路治疗的110例精囊腺炎患者作为经前列腺小囊内破壁入路组。观察两组的手术成功率、手术时间、术后带尿管率﹑术后症状改善率和并发症发生率。结果两组精囊腺炎患者的术前一般病情资料比较, 差异无统计学意义(P>0.05);术后经前列腺小囊颈口外入路组的手术成功率明显高于经前列腺小囊内破壁入路组(P<0.05), 而手术时间、术后带尿管率明显降低(P<0.05), 疼痛症状的缓解率﹑下尿路症状缓解率﹑阴囊潮湿缓解率﹑血精缓解率均明显增高(均P<0.05)。两组均未发生严重的并发症。结论钬激光辅助下经前列腺小囊颈口外入路方法, 具有手术成功率高、手术时间短, 手术效果好的优点, 值得在临床中推广应用。

Objective To explore the method of seminal vesicle endoscopy with high success rate and effective in the treatment of seminal vesiculitis.Methods The clinical data of 160 patients with seminal vesiculitis who were treated with holmium laser assisted by external approach of prostatic vesiculitis cervicalis in our hospital from April 2020 to September 2021 were retrospectively analyzed(in the group of external approach of prostatic vesiculitis cervicalis,the entry was made at 5 or 7 o'time).Another 110 cases of seminal vesiculitis patients who were treated by holmium laser assisted transprostatic vesicular wall-breaking approach in our hospital from January 2018 to April 2020 were selected as the transprostatic vesicular wall-breaking approach group.The operation success rate,operation time,the rate of urinary catheter,the rate of symptom improvement and the incidence of complications were observed in the two groups.Results There was no significant difference in preoperative general data between the two groups(P>0.05).The success rate of the operation was significantly higher in the external prostatic sac group than that in the internal prostatic sac group(P<0.05),the operation time and the rate of urinary catheterization were significantly reduced(all P<0.05),and the relief rate of pain symptoms,lower urinary tract symptoms,scrotal moisture and blood sperm were significantly increased(all P<0.05).No serious complications occurred in either group.Conclusions Compared with common clear cell renal carcinoma,patients with cystic renal cell carcinoma have lower clinical stage,lower proportion of tumor progression and laser has the advantages of high success rate of the operation,short operation time and good operation effect,and it is worthy of popularization and application in clinical practice.