CAJ | 학술논문

目的改进精囊镜技术,提高精囊镜在精囊病变诊治中的临床应用效果. 方法 2010年9月到2013年8月,以头端弯曲的专利导管引导精囊镜经精阜隐窝进入前列腺小囊,于其底部5、7点处的侧壁上,以另一种专利导管穿刺、引导精囊镜进入到精囊腔内.对58例患者,包括42例顽固性血精和16例无精子症者,进行相应处理. 结果本组应用改进方法自前列腺隐窝进到精囊腔的时间仅需2 ～3 min,顺利进镜到精囊腔内46例,占79％.16例临床无精子症者中12例(75％)未见明显隐窝,怀疑精道梗阻,改用电切镜切除精阜隆起,直接进入前列腺小囊和精囊腔内.术后随访6～36个月(平均18个月),42例血精患者症状消失25例(60％),改善11例(26％),16例无精子症者中6例治愈,5例好转,5例无变化.19例术后行顺行下尿路造影均未见造影剂反流.结论以专利导管引导精囊镜,可经精阜隐窝和前列腺小囊快速进入精囊腔,操作技术简单易行,并对不同精囊病变进行处理,成功率高,无并发症,是一种实用的临床技术.
목적 개진정낭경기술,제고정낭경재정낭병변진치중적림상응용효과. 방법 2010년9월도2013년8월,이두단만곡적전리도관인도정낭경경정부은와진입전렬선소낭,우기저부5、7점처적측벽상,이령일충전리도관천자、인도정낭경진입도정낭강내.대58례환자,포괄42례완고성혈정화16례무정자증자,진행상응처리. 결과 본조응용개진방법자전렬선은와진도정낭강적시간부수2 ～3 min,순리진경도정낭강내46례,점79％.16례림상무정자증자중12례(75％)미견명현은와,부의정도경조,개용전절경절제정부륭기,직접진입전렬선소낭화정낭강내.술후수방6～36개월(평균18개월),42례혈정환자증상소실25례(60％),개선11례(26％),16례무정자증자중6례치유,5례호전,5례무변화.19례술후행순행하뇨로조영균미견조영제반류.결론 이전리도관인도정낭경,가경정부은와화전렬선소낭쾌속진입정낭강,조작기술간단역행,병대불동정낭병변진행처리,성공솔고,무병발증,시일충실용적림상기술.
Objective To refine the technique and improve the efficacy of seminal vesiculoscopy in the diagnosis and treatment of seminal vesicle disease.Methods The refined techniques of seminal vesculoscopy,using a patent catheter into the slit-like ejaculatory duct orifice through the verumontanum and another patent catheter introduced into seminal vesicle lumen,were performed in 58 cases,including intractable hematospermia in 42 cases and azoospermia in 16 cases.Results Seminal vesiculoscopy was successfully entered into the seminal vesicular lumen in 46 patients (79％) within 2-3 min.There was no obvious ejaculatory duct orifice in 12 of 16 azoopermia cases,and transurethral resection of verumontanum was performed,then seminal vesiculoscope was directly entered into seminal vesicle lumen.Symptoms of hematospermia were disappeared in 25 cases (60％),improved in 11 cases (26％),and azoospermia were cured in 6 cases (37％),improved in 5 (31％),unchanged in 5 (31％) during the follow-up period of 6-36 months (average 18 months).There were no major or minor complications in this series,and no urine reflux into ejaculatory duct in 19 cases demonstrated by contrast medium.Conclusion Refined seminal vesiculoscopy was technically safe,efficient,simple,and potentially widely used in the cases of hematospermia and ejaculatory duct obstructions.