可视化经皮肾镜在精囊镜检中的临床应用

doi:10.19558/j.cnki.10-1020/r.2021.04.007

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摘要 目的: 探讨可视化经皮肾镜行精囊镜检的安全性和有效性。方法: 选取2017年6月–2019年12月收治的血精患者15例进行研究,患者均在麻醉下应用可视化经皮肾镜行精囊镜检术,评估手术效果及术后并发症发生情况。结果： 15例患者均成功完成可视化经皮肾镜下精囊镜检术,手术时间40~95（70.20±16.13）min;术中发现6例单侧精囊结石、3例双侧精囊结石以及1例前列腺小囊内结石,分别行钬激光碎石术;4例患者可见精囊充血伴精浆混有暗红色血凝块,诊断为精囊炎并给予冲洗及灌注药物治疗;1例患者双侧精囊腔内精浆呈脓性伴双侧射精管口狭窄,置入筋膜扩张器行射精管口扩张,冲洗精囊腔,将脓性液体送结核DNA检查为诊断精囊结核,行抗结核治疗。住院时间9~11（9.67±0.82）d;术后随访3~9个月,所有患者术后3个月血精症状均消失,1例患者术后5个月再次出现血精,用可视化经皮肾镜行精囊镜检,提示精囊结石,给予钬激光碎石后症状缓解;所有患者术中无直肠、前列腺及尿道损伤,术后无附睾炎及逆行射精情况。结论： 可视化经皮肾镜行精囊镜检术安全、有效、并发症低,临床应用价值高。

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	但超
	姚启盛
	王黎
	龚小新
	王俊霖
	杨勇

关键词 ：可视化经皮肾镜, 精囊镜, 血精, 临床应用

Abstract：Objective: To explore the safety and efficacy of visual mirco-percutaneous nephrolithotomy in seminal vesiculoscopy. Methods： The clinical data of 15 patients with hematospermia from June 2017 to December 2019 were analyzed. All patients were given seminal vesiculoscopy with visual micro-percutaneous nephrolithotomy under anesthesia. The operation curative effect and postoperative complications were evaluated. Results： All patients were subjected to seminal vesiculoscopy with visual micro-percutaneous nephrolithotomy successfully. The average operation time was 40-95 （70.20±16.13） min. A total of 6 cases of unilateral seminal vesicle calculus, 3 cases of bilateral seminal vesicle calculus and 1 case of prostate utricle vesicle were found during the operation by holmium laser lithotripsy, respectively. Seminal vesicle congestion and dark red blood clot were observed in 4 patients, seminal vesiculitis was diagnosed, irrigation and drug infusion were performed. There was one case of purulent seminal plasma in bilateral seminal vesicle accompanied by bilateral ejaculatory orifical stenosis, a fascia dilator for ejaculatory orifical dilation was implanted, the seminal vesicle was rinsed with normal saline, the purulent fluid was sent to the tuberculosis DAN examination before the diagnosis of the seminal vesicle tuberculosis, and anti-tuberculosis treatment was given. The average hospital stay was 9-11 （9.67±0.82） days. The patients were followed up for 3-9 months after the operation, and all the symptoms of hematospermia disappeared 3 months after the operation. Hematospermia recurred 5 months after the operation, seminal vesicle calculus was revealed by seminal vesiculoscopy with visual micro-percutaneous nephrolithotomy, and symptoms were relieved after holmium laser lithotripsy. There were no complications such as rectal injury, prostate injury and urethra injury during the operation. The postoperative complications such as epididymitis and retrograde ejaculation were not observed. Conclusion： Visual mirco-percutaneous nephrolithotomy in seminal vesiculoscopy is safe and effective, and has low complications, with high clinical value.

Key words： visual mirco-percutaneous nephrolithotomy seminal vesiculoscopy hematospermia clinical application

收稿日期: 2020-08-22

基金资助:太和医院院级基金项目（2020JJXM071）

通讯作者: 杨勇,yy8801456@126.com

引用本文:

但超, 姚启盛, 王黎, 龚小新, 王俊霖, 杨勇. 可视化经皮肾镜在精囊镜检中的临床应用[J]. 微创泌尿外科杂志, 2021, 10(4): 247-250.
DAN Chao, YAO Qisheng, WANG Li, GONG Xiaoxin, WANG Junlin, YANG Yong. Clinical Application of Visual Micro-Percutaneous Nephrolithotomy in Seminal Vesiculoscopy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(4): 247-250.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1690.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2021/V10/I4/247

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