精囊镜治疗难治性血精症的疗效分析  

Transurethral seminal vesicuioscopy in the treatment of refractory hemospermia

作　　者：向旭宇[1] 黄珂[1] 唐正严[1] 黄亮[1] 陈俊杰[1] 薛睿智 Xiang Xuyu , Huang Ke , Tang Zhengyan , Huang Liang ,Chen Junjie , Xue Ruizhi.(Department of Urology, Xiangya Hospital, Central South University, Hunan Engineering Laboratory for Diagnosis and Treatment Technology of Urogenital Diseases, Changsha 410008, Chin)

机构地区：[1]中南大学湘雅医院泌尿外科泌尿生殖系统疾病诊疗技术湖南省工程实验室,长沙410008

出　　处：《中华泌尿外科杂志》2018年第3期205-208,共4页Chinese Journal of Urology

摘　　要：目的探讨经尿道精囊镜治疗精囊腺疾病所致难治性血精症的疗效。 方法回顾性分析2012年2月至2014年2月收治的50例精囊腺疾病所致难治性血精症患者的临床资料。患者年龄（39.2±9.2）岁；病程（7.4±2.6）个月；其中精囊腺炎24例，精道梗阻10例，精囊腺结石16例。根据患者主观意愿行精囊镜手术（手术组）或保守治疗（保守组）。手术组38例，年龄（38.9±8.8）岁；病程（7.5±2.5）个月；精囊腺炎18例，精道梗阻8例，精囊腺结石12例；精液镜检RBC（3.71±0.46）个/HP，WBC（2.50±0.15）个/HP；血精率0.80±0.20，生活质量评分（4.47±0.51）分。保守组12例，年龄（40.2±10.5）岁；病程（7.3±2.9）个月；精囊腺炎6例，精道梗阻2例，精囊腺结石4例；精液镜检RBC（3.83±0.39）个/HP，WBC（2.87±0.06）个/HP；血精率0.75±0.25，生活质量评分（2.50±0.52）分。两组的年龄、病程、疾病构成比较差异均无统计学意义（P〉0.05）。比较两组患者治疗前与治疗后第1、3、6、12个月精液WBC和RBC计数、血精率、生活质量评分，以及两组治疗后1、3、6、12个月的痊愈率及好转率。 结果两组治疗后1、3、6、12个月的精液WBC和RBC计数、血精率、生活质量评分较治疗前均明显下降，差异有统计学意义（P〈0.05）。在治疗过程中，保守组患者均未发生不良反应，手术组1例出现感染，予左氧氟沙星治疗1 d后好转。治疗后6个月，手术组痊愈率为55.2%（21/38），好转率为36.8%（14/38）；保守组痊愈率为25.0%（3/12），好转率为25.0%（3/12）；治疗后12个月，手术组痊愈率为60.5%（23/38），好转率为34.2%（13/38）；保守组痊愈率为8.3%（1/12），两组比较差异有统计学意义（χ2＝8.29；χ2＝26.34，P〈0.05）。 结论经尿道精囊镜手术对精囊腺疾病所致难治性血精症有一定疗效，尤其在长期（治疗后12个月）疗效的�ObjectiveTo discuss the clinical effects of transurethral seminal vesiculoscopy in refractory hemospermia caused by seminal vesicle diseases. MethodsThe clinical data of 50 patients suffered from refractory hemospermia caused by seminal vesicle gland diseases were retrospectively analyzed from February 2012 to February 2014. Patients’ age varied from 25 to 54 years old, mean（39.2±9.2）years. The course of disease was （7.44±2.6） months. There were 24 seminal vesiculitis, 10 seminal ducts obstruction disease, and 16 seminal vesicle calculi disease. According to patients’ priority, the patients were divided into surgical treatment group and conservative treatment group. In surgical group, there were 38 patients with age of （38.9±8.8） years old , and the course of disease was （7.5±2.5） months. There were 18 seminal vesiculitis, 8 seminal ducts obstruction, and 12 seminal vesicle calculi. Whereas in conservative treatment group, there were 12 patients, with age of （40.2±10.5） years old, and the course of disease was （7.3±2.9） months. Among them, there were 6 seminal vesiculitis, 2 seminal ducts obstruction, and 4 seminal vesicle calculi. There was no significant difference between the two groups in patients age, course of disease and constitution of disease. The clinical data derived from the two treatment groups including the white blood cell counts （WBC） and red blood cell counts （RBC） in the seminal fluid, hematospermia rate, quality of life score, cure rate and improvement rate before and after the treatment were analysed. Results1, 3, 6 months and 1 year after treatment, all observation indexes in the two groups had been ameliorated and had significant difference compared with those before treatment including WBC and RBC in the seminal fluid, hematospermia rate and quality of life score. No operative complications occurred in conservative treatment group. While a patient in surgical treatment group suffered from infection and recovered after levofloxacin treatment fo

关 键 词：精囊腺疾病 血精症 精囊镜 

分 类 号：R699.8[医药卫生—泌尿科学]