CAJ | 학술논문

目的：对比分析输尿管镜下钬激光内切开与单纯输尿管镜精道检查治疗顽固性血精的疗效。方法2003年12月至2013年4月顽固性血精患者67例均行精液分析、经直肠前列腺、精囊彩超检查,部分患者行盆腔CT或MRI检查。结果24例行单纯输尿管镜精道检查,43例行输尿管镜下钬激光内切开,均有不同程度的射精管开口狭窄或梗阻。术后随访6个月至3年,行单纯输尿管镜精道检查患者中有2例分别术后6个月、8个月血精复发,再次手术,发现射精管开口狭窄,行钬激光内切开术,术后血精消失,未发生逆行射精、尿失禁或直肠损伤等并发症。结论输尿管镜钬激光内切开较单纯输尿管镜精道检查治疗顽固性血精疗效更好,是否值得临床推广应用,还需进一步观察总结。
목적：대비분석수뇨관경하화격광내절개여단순수뇨관경정도검사치료완고성혈정적료효。방법2003년12월지2013년4월완고성혈정환자67례균행정액분석、경직장전렬선、정낭채초검사,부분환자행분강CT혹MRI검사。결과24례행단순수뇨관경정도검사,43례행수뇨관경하화격광내절개,균유불동정도적사정관개구협착혹경조。술후수방6개월지3년,행단순수뇨관경정도검사환자중유2례분별술후6개월、8개월혈정복발,재차수술,발현사정관개구협착,행화격광내절개술,술후혈정소실,미발생역행사정、뇨실금혹직장손상등병발증。결론수뇨관경화격광내절개교단순수뇨관경정도검사치료완고성혈정료효경호,시부치득림상추엄응용,환수진일보관찰총결。
Objective To analyse the effect of holmium laser incision through ureteroscopy and simple ureteroscopy treatment for refrac-tory hemospermia. Methods From December 2003 to April 2013,the data of 67 cases with refractory hemospermia were retrospectively ana-lyzed. All the patients underwent semen analysis,transrectal ultrasonography,seminal vesicle ultrasonography,some patients underwent pelvic CT or MRI. Results Simple ureteroscopy were done for 24 cases,holmium laser incision through ureteroscopy were done for 43 cases. Var-ying degrees of ejaculatory duct stenosis or obstruction were observed. Postoperative follow-up was from 6 months to 8 years,in 24 cases of simple ureteroscopy,2 cases experienced recurrence 6 or 8 months later. The ejaculatory duct narrow were found when they received reopera-tion,with holmium laser incision,hemospermia disappeared. No complications such as retrograde ejaculation,urinary incontinence or rectal injury occurred postoperatively. Conclusion The effect of holmium laser incision through ureteroscopy for refractory hemospermia is better than simple ureteroscopy,which is worthy of clinical application needs further observation and summary.