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目的:探讨经尿道精囊镜技术在精囊疾病诊治中的临床应用价值。方法:回顾性分析我院泌尿外科2009年10月~2013年2月采用经尿道精囊镜治疗顽固性血精52例患者的临床资料,并结合文献复习临床常见的精囊疾病的病因和诊治方法。本组患者均由药物及物理疗法治疗3个月无效。术前完善常规检查后,进行精囊灌洗,射精管扩张、钬激光碎石以及精囊囊肿去顶等治疗,术后定期随访。结果:本组52例均进镜成功,镜检示血精36例,精囊慢性炎症27例,精囊囊肿18例,精囊结石17例,射精管梗阻16例,精囊脓肿合并附睾结核1例,精囊淀粉样变3例,精囊肉芽肿1例。术后随访3~12个月,2例术后出现急性附睾炎,给予抗感染治疗后治愈,未出现尿失禁、急性前列腺炎和直肠损伤等并发症。结论:经尿道精囊镜技术在对精囊疾病进行检查的同时也可以治疗精囊疾病,是诊断治疗精囊疾病的一种安全、有效、微创的新技术,值得临床推广。
Objective: To investigate the clinical value of transurethral seminal vesicle mirror technique in diagnosis and treatment of seminal vesicle disease. Methods: A retrospective analysis of clinical data of 52 cases of refractory semen treated with transurethral seminal vesicle mirror in our hospital from October 2009 to February 2013 were retrospectively reviewed. The etiology and diagnosis and treatment of seminal vesicle disease were reviewed in the literature. The patients were treated by drugs and physical therapy 3 months invalid. Perfecting the routine examination before surgery, seminal vesicle lavage, ejaculatory duct dilatation, holmium laser lithotripsy and seminal vesicle cyst to the top and other treatment, regular follow-up. Results: All the 52 cases were successfully enrolled in this study. Thirty-six cases of seminal vesicle, 27 cases of seminal vesicle chronic inflammation, 18 cases of seminal vesicle cysts, 17 cases of seminal vesicle stones, 16 cases of ejaculatory duct obstruction, 1 case of seminal vesicle abscess and epididymal tuberculosis, 3 cases of amyloidosis, 1 case of seminal vesicle granuloma. The patients were followed up for 3 to 12 months. Two patients had acute epididymitis after operation and were cured after anti-infective treatment. No complications such as urinary incontinence, acute prostatitis and rectal injury occurred. Conclusion: Transurethral seminal vesicle mirror technique can be used to diagnose seminal vesicle disease while examining seminal vesicle disease. It is a safe, effective and minimally invasive new technique for diagnosis and treatment of seminal vesicle disease. It is worthy of clinical promotion.