顽固性血精患者经尿道精囊镜临床诊治研究.docVIP

顽固性血精患者经尿道精囊镜临床诊治研究 　　【摘要】目的：观察分析顽固性血精患者经尿道精囊镜的临床应用。方法：选取2011年3月至2013年3月收治的顽固性血精患者共38例。随机将患者分为观察组和对照组，其中观察组患者采用经尿道精囊镜进行诊治；对照组采用超声引导精囊穿刺置管治疗。结果：入选38例患者导致其发生血精的原因，其中精囊壁射精管炎症为主要原因，占39.5%，其次是精囊结石和射精管出血。术中出血量等对比对照组均相对较少。观察组的治愈率为95.0%明显高于对照组的83.3%；术后的并发症中，对照组明显要比观察组多。观察组患者的精子质量明显要高于对照组，而复发率则要比对照组低。结论：采用经尿道精囊经治疗顽固性血精能够有效改善患者血精症状，治疗方法相对安全，治疗效果显著。 　　【关键词】顽固性血精；经尿道精囊镜；临床诊治 　　【Abstract】Objectives： To investigate the clinical application of transurethral seminal vesiculoscopy for patients with intractable hematospermia. Methods： 38 patients with intractable hematospermia in our hospital from March 2011 to March 2013 were selected and randomly divided into observation group and control group， in which the observation group was treated with transurethral seminal mirror for diagnosis and treatment， and the control group used ultrasound-guided seminal vesicle catheterization for treatment. Results： Of the 38 patients enrolled， 39.5% were caused by ejaculatory duct inflammation， followed by the seminal vesicles and ejaculatory duct calculi bleeding. The control group had relatively less blood loss. The cure rate was 95.0% in the observation group， which was significantly higher than that of the control group of 83.3%. For postoperative complications， the control group had more than the observation group. The sperm quality of the observation group was significantly higher， while the recurrence rate was lower than that in the control group. Conclusion： Transurethral vesiculoscopy can improve symptoms of patients in the treatment of intractable hematospermia， with relatively safe and significant treatment effect. 　　【Key words】Intractable hematospermia； Transurethral vesiculoscopy； Clinical diagnosis 　　【中图分类号】R167【文献标志码】A 　　血精是指精液中出现血液的一类疾病，一般血精被认为是良性的，并且可以通过保守药物治疗，血精多见于40岁以下的患者[1]。但部分血精患者接受药物治疗后仍不能得到有效的缓解，称之为顽固性血精。虽然血精属于良性，诱因多数为自限性疾病，但对于患者的心理影响会相对较大。多种疾病均有可能会引起患者出现血精。其中顽固性血精，特别是年龄相对较大的患者，若其临床反复出现血精症状，应该要考虑是否为前列腺癌。因而能够及早发现引起顽固性血精的病因是至关重要的[2]。血精的诊断方法有MRI，超声影像以及精囊镜等[3]。本文主要是探讨经尿道精囊