一种新技术.doc

经尿道微创精囊电切术治疗精囊疾病 李彦锋，梁培和，孙中义，张 军，张克勤，张 勇，霍文谦，毕 罡，靳风烁 （400042 重庆，第三军医大学大坪医院野战外科研究所泌尿外科） [摘要] 目的 寻求和评价临床治疗严重精囊疾病和血精的新方法，为保守治疗无效的该类患者提供新的治疗措施。方法 5例经长期保守治疗无效，存在明显精囊部症状或血精症状患者（年龄48～77岁，平均55.4岁），病史4～10年，平均7.2年。采用经尿道途径，通过精囊外入路和/或精囊内入路，分别进行了精囊电切除术或电灼治疗。结果 5例患者均成功进行电切或电灼治疗，手术时间50～65 min，失血量20～50 ml。无术中或术后并发症发生，术后病理均证实：所切除精囊组织显非特异性慢性炎症。所有患者随访4～12个月，均述术前症状消失，恢复性生活后，存在射精和性高潮快感。结论 作为一种全新的精囊微创治疗技术，经尿道微创精囊电切术适用于长期慢性血精或其他严重精囊疾病且保守治疗无效的患者，可在严格掌握指证下推广应用。 [关键词] 精囊疾病；血精；电切；微创治疗 [中图法分类号] [文献标志码] A Treatment of severe seminal vesicle disease with minimally invasive transurethral electro-resection of seminal vesicle Li Yanfeng, Zhang Keqin, Liang Peihe, Sun Zhongyi，Huo Wenqian，Bi Gang，Jin Fengshuo (Department of Urology, Daping Hospital, Institute of Field Surgery, Third Military Medical University, Chongqing 400042, China) [Abstract] Objective To find the novel treatment method of severe seminal vesicle (SV) disease and hemospermia for those who fail to respond to other treatment modalities. Methods Five patients at the age of 48-77 years (mean 55.4 years), who had significant symptoms of SV disease and hemospermia for 4-10 years that failed to respond to conservative treatment, underwent transurethral electro-resection or electric cauterization of SV through extra- or intra-seminal vesicle approach. Results Transurethral electro-resection or electric cauterization of SV was successfully performed for the 5 patients. The operation time was 50-65 min and the amount of blood loss in patients was 20-50 mL. No complication occurred during or after operation. Pathological examination after operation showed non–specific chronic inflammation in the resected SV tissue. The patients were followed up for 4?2 months, during which their pre-operation symptoms disappeared and their sexual life was recovered with hedonia. eConclusion As a brand-new procedure, minimally invasive transurethral electro-resection of SV can be performed for those