Zinner综合征的诊治经验:基于1999—2020年中国25例病例的最新汇总分析  

Treatment and diagnosis experience of Zinner syndrome:an updated pooled analysis based on 25 cases in China from 1999 to 2020

作　　者：卢扬柏[1] 张泳欣 黎卫[1] 冷区 黄亚强[1] 王强 袁润强[1] 黄红星[1] Lu Yangbai;Zhang Yongxin;Li Wei;Leng Qu;Huang Yaqiang;Wang Qiang;Yuan Runqiang;Huang Hongxing(Department of Urological Surgery,Zhongshan City People's Hospital,Zhongshan 528403,China;Department of MR,Zhongshan City People's Hospital,Zhongshan 528403,China)

机构地区：[1]中山市人民医院泌尿外科,广东528403 [2]中山市人民医院MR室,广东528403

出　　处：《国际医药卫生导报》2021年第9期1300-1305,共6页International Medicine and Health Guidance News

基　　金：2019年中山市医学科研项目(2019J042);2019年中山市科技计划项目(2019B1063);2020年中山市科技计划项目(2020B1073)。

摘　　要：目的探讨先天性精囊囊肿合并同侧肾发育不良或缺如这种罕见疾病的诊断及治疗,提高对Zinner综合征的认识。方法对1999年1月至2020年5月发表于国内期刊的精囊囊肿合并同侧肾发育不全23例及2016年8月至2020年8月本院诊断的2例患者的诊断年龄、患侧(R/L)、症状、诊断性检查、治疗和预后进行合并分析。结果平均诊断年龄为35.65岁,72.0%的患者发病时的年龄在11~40岁之间,13例(52.0%)患者的精囊囊肿和肾发育不全位于左侧,12例(48.0%)位于右侧,R︰L≈1︰1。最常见的症状为:尿急(27.3%,6/22)、会阴痛(27.3%,6/22)、尿频(22.8%,5/22)和排尿困难(18.2%,4/22)。最常见的检查是经直肠指检(DRE,88.0%,22/25)、经腹部B超检查(84.0%,21/25)、CT(64.0%,16/25)及MRI(60.0%,15/25)。手术切除是最常用的治疗方法,共18例(72.0%),其中开腹手术7例,腹腔镜手术10例,机器人辅助腹腔镜膀胱部分切除术1例,成功率100.0%,经尿道囊肿去顶术1例,囊肿抽液及引流术4例(17.4%),复发率100.0%。结论精索囊肿合并同侧肾发育不全是一种罕见泌尿系统异常,发病常见于11~40岁,最常见的症状为尿急、会阴痛、尿频和排尿困难。常见的诊断性检查包括腹部B超检查、经直肠指检、CT及MRI检查,手术精囊切除和经尿道手术囊肿去顶术效果良好,囊肿抽液及引流术复发率高,适用于囊肿疾病活检诊断。Objective To explore the diagnosis and treatment of a rare urological anomaly,congenital seminal vesicle cysts complicated with ipsilateral renal agenesis,and to improve the diagnosis and treatment of Zinner syndrome.Methods A pooled analysis was performed on the age,laterality(R/L),symptoms,diagnostic examinations,treatment,and outcomes of 25 patients with seminal vesicle cysts and ipsilateral renal agenesis published in Chinese journals from January,1999 to May,2000.Results The mean age at diagnosis was 35.65.Seventy-two percent patients got the disease when they were 11-40 years old.Thirteen cases(52.0%)got seminal vesicle cysts and ipsilateral renal agenesis on the left side,and 12(48.0%)on the right side.The R︰L was about 1︰1.The most common symptoms were urgent micturition(27.3%,6/22),perineal pain(27.3%,6/22),frequent micturition(22.8%,5/22),and dysuria(18.2%,4/22).The cyst was felt by directeral rectum examination(DRE)in 88.8%(22/25)patients.The most common examinations were transabdominal ultrasound(84.0%,21/25),DRE(88.0%,22/25),CT(64.0%,16/25),and magnetic resonance imaging(72.0%,18/25).Surgical resection was the most common treatment,and 18 cases took it,including laparotomy for 7 cases,laparoscopic surgery for 10 cases,and laparoscopic partial cystectomy assisted by robot for 1 case;the surgical successful rate was 100.0%.One case took transurethral deroofing of the cyst,and 4(17.4%)took aspiration and drainage;the recurrence rate after aspiration and drainage was 100.0%.Conclusion Seminal vesicle cysts complicated with ipsilateral renal agenesis is a rare urological anomaly,and occurs when the patients are 11-40 years old.Its common symptoms are urgent micturition,perineal pain,frequent micturition,and dysuria.The common diagnostic examinations are abdominal ultrasonography,DRE,CT,and magnetic resonance imaging.Seminal vesicle resection and transurethral deroofing of the cyst have excellent results.Aspiration and drainage of the cyst has a high recurrence rate and should only be used for diagnost

关 键 词：Zinner综合征 症状 诊断性检查 治疗 手术治疗 

分 类 号：R697.4[医药卫生—泌尿科学] R692[医药卫生—外科学]