中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2011年
8期
558-560
,共3页
叶利洪%蒋小强%李雨林%陈永良%陶水祥%尚庆亚%钱卫良%何建松%李王坚
葉利洪%蔣小彊%李雨林%陳永良%陶水祥%尚慶亞%錢衛良%何建鬆%李王堅
협리홍%장소강%리우림%진영량%도수상%상경아%전위량%하건송%리왕견
血精%输尿管镜%内镜外科手术
血精%輸尿管鏡%內鏡外科手術
혈정%수뇨관경%내경외과수술
Hematospermia%Ureteroscopy%Endoscopic surgical procedures
目的 探讨精囊镜技术在血精诊治中的应用价值.方法 顽固性血精患者19例,经直肠超声,精囊MRI或CT扫描等检查排除精囊肿瘤、结核、前列腺占位,行前列腺液培养加药敏试验.4.5～6.0 F输尿管镜经尿道于射精管口直视下进镜,入囊后镜检,冲洗精囊内陈旧性血块;精囊结石用钬激光碎石;切除微小息肉;喹诺酮类药物0.3g/100 ml精囊保留灌注.结果 19例患者中,18例行双侧1例行患侧精囊镜检、冲洗及药物保留灌注;5例并发精囊结石者以钬激光碎石;3例微小息肉成功切除.手术时间10～75 min,平均35 min;术中、术后无并发症发生.18例术后3个月血精完全消失,随访6～12个月,血精所致症状消失;1例术后5个月血精复发经敏感抗生素治疗后好转.结论 4.5～6 F输尿管镜经正常解剖路径行精囊镜检及相关治疗是微创、安全、有效治疗顽固性血精的方法.
目的 探討精囊鏡技術在血精診治中的應用價值.方法 頑固性血精患者19例,經直腸超聲,精囊MRI或CT掃描等檢查排除精囊腫瘤、結覈、前列腺佔位,行前列腺液培養加藥敏試驗.4.5～6.0 F輸尿管鏡經尿道于射精管口直視下進鏡,入囊後鏡檢,遲洗精囊內陳舊性血塊;精囊結石用鈥激光碎石;切除微小息肉;喹諾酮類藥物0.3g/100 ml精囊保留灌註.結果 19例患者中,18例行雙側1例行患側精囊鏡檢、遲洗及藥物保留灌註;5例併髮精囊結石者以鈥激光碎石;3例微小息肉成功切除.手術時間10～75 min,平均35 min;術中、術後無併髮癥髮生.18例術後3箇月血精完全消失,隨訪6～12箇月,血精所緻癥狀消失;1例術後5箇月血精複髮經敏感抗生素治療後好轉.結論 4.5～6 F輸尿管鏡經正常解剖路徑行精囊鏡檢及相關治療是微創、安全、有效治療頑固性血精的方法.
목적 탐토정낭경기술재혈정진치중적응용개치.방법 완고성혈정환자19례,경직장초성,정낭MRI혹CT소묘등검사배제정낭종류、결핵、전렬선점위,행전렬선액배양가약민시험.4.5～6.0 F수뇨관경경뇨도우사정관구직시하진경,입낭후경검,충세정낭내진구성혈괴;정낭결석용화격광쇄석;절제미소식육;규낙동류약물0.3g/100 ml정낭보류관주.결과 19례환자중,18례행쌍측1례행환측정낭경검、충세급약물보류관주;5례병발정낭결석자이화격광쇄석;3례미소식육성공절제.수술시간10～75 min,평균35 min;술중、술후무병발증발생.18례술후3개월혈정완전소실,수방6～12개월,혈정소치증상소실;1례술후5개월혈정복발경민감항생소치료후호전.결론 4.5～6 F수뇨관경경정상해부로경행정낭경검급상관치료시미창、안전、유효치료완고성혈정적방법.
Objective To treat hematospermia by ureteroscopy and investigate its application value for the treatment of hematospermia.Methods Nineteen patients with persistent hematospermia, TRUS,seminal vesicle MRI or CT were examined to exclude seminal vesicle tumor, tuberculosis, prostatic occupancy and preoperative prostatic fluid and drug sensitivity.Transurethral 4.5 - 6 F ureteroscopy entered through the microscopic seminal vesicle, wash of the old blood, reserved perfusion with Quinolones, and the lithoclasty on the seminal stones by holmium laser, resection of small polypi.Results The ureteroscopy was successful in 18 (95%) cases for bilateral seminal vesicle, wash and drug reserved perfusion, and one case was also successful seminal vesicle microscopy on the affected side; five cases with the seminal stones by olmium laser, three cases with small polypi by resection.The averse duration of the procedure was 35 10 -75) min.There were no compliocations during or after the operation.In 18 cases at 6 - 12 months follow-up the hematospermia and symptoms of hematospermia disappeared fully after 90 d.There was recurrence in one case which improved with anti-inflammaotry treatment.Conclusions Ureteroscopic treatment for persistent hematospermia by 4.5 - 6 F ureteroscopy through the seminal vesicle is effective and safe method and results in a micro-wound.
