经尿道精囊镜技术在血精症患者诊治中的临床价值探析
|
摘要
目的探讨经尿道精囊镜手术治疗血精症患者的临床效果及安全性,以及对患者性生活质量的影响。方法选择2014年2月至2017年1月重庆市涪陵中心医院诊治的经单纯药物治疗反复发作的60例血精患者为研究对象,根据医生建议、患者自愿的原则,将其分为观察组和对照组。观察组28例患者,采用经尿道精囊镜手术治疗;对照组32例患者,采用综合保守治疗。两组患者分别于治疗前、治疗完成3个月后,取精液于精液镜下计数红细胞和白细胞数并进行比较。完成治疗后3个月随访,根据患者临床症状改变、精液质量检查和B超检查结果,判断两组患者的临床治疗效果。比较两组患者治疗前、治疗后3个月勃起功能(IIEF-5)、射精功能(CIPE)评分。结果完成治疗3个月后,观察组患者精液红细胞计数和白细胞计数均明显低于对照组患者(均P<0.05)。完成治疗后3个月随访评价临床疗效,观察组患者临床总有效率明显高于对照组患者(P<0.05)。完成治疗3个月后,观察组患者IIEF-5评分、CIPE评分均明显高于对照组患者(均P<0.05)。结论经尿道精囊镜技术治疗血精症患者临床效果明显优于综合保守治疗,可以有效消除患者血精临床症状,提高患者性生活质量。
Objective To investigate the clinical efficacy and safety of transurethral seminal vesiculoscopy surgery for patients with hematospermia, and the impact on quality of sexual life of patients. Methods 60 patients with recurrent hematospermia treated by simple drug treatment in Fuling Central Hospital from February 2014 to January 2017 were selected and divided into the observation group(28 cases) and control group(32 cases) according to doctor′s suggestion and the principle of voluntary. The observation group received transurethral seminal vesiculoscopy surgery while the control group received comprehensive conservative treatment. The number of red blood cells and leukocytes was counted and compared between before treatment and 3 months after treatment. All the patients were followed up for 3 months after completion of the treatment, the clinical treatment effect of the two groups was judged and compared according to the changes in the clinical symptoms, the quality of semen and the results of B-ultrasound examination. The scores of erectile function(IIEF-5) and ejaculatory function(CIPE) were compared between the two groups before treatment and 3 months after treatment. Results At 3 months after treatment, the red blood cell count and leukocyte count in the semen in the observation group were significantly lower than those in the control group(all P<0.05). Within the 3 months′ follow-up, the clinical efficacy was evaluated. The total effective rate in the observation group was significantly higher than that in the control group(P<0.05). The IIEF-5 score and CIPE score in the observation group were significantly higher than those in the control group(all P<0.05). Conclusions Transurethral seminal vesiculoscopy is of better effect than conservative treatment in the treatment of hemospermia patients, which can effectively eliminate the clinical symptoms of patients and improve the quality of sexual life of patients.
Objective To investigate the clinical efficacy and safety of transurethral seminal vesiculoscopy surgery for patients with hematospermia, and the impact on quality of sexual life of patients. Methods 60 patients with recurrent hematospermia treated by simple drug treatment in Fuling Central Hospital from February 2014 to January 2017 were selected and divided into the observation group(28 cases) and control group(32 cases) according to doctor′s suggestion and the principle of voluntary. The observation group received transurethral seminal vesiculoscopy surgery while the control group received comprehensive conservative treatment. The number of red blood cells and leukocytes was counted and compared between before treatment and 3 months after treatment. All the patients were followed up for 3 months after completion of the treatment, the clinical treatment effect of the two groups was judged and compared according to the changes in the clinical symptoms, the quality of semen and the results of B-ultrasound examination. The scores of erectile function(IIEF-5) and ejaculatory function(CIPE) were compared between the two groups before treatment and 3 months after treatment. Results At 3 months after treatment, the red blood cell count and leukocyte count in the semen in the observation group were significantly lower than those in the control group(all P<0.05). Within the 3 months′ follow-up, the clinical efficacy was evaluated. The total effective rate in the observation group was significantly higher than that in the control group(P<0.05). The IIEF-5 score and CIPE score in the observation group were significantly higher than those in the control group(all P<0.05). Conclusions Transurethral seminal vesiculoscopy is of better effect than conservative treatment in the treatment of hemospermia patients, which can effectively eliminate the clinical symptoms of patients and improve the quality of sexual life of patients.
引文
[1] 张卫星,常轲祎,王瑞,等.20例血精症患者精液细菌培养及药敏结果分析[J].中国现代医学杂志,2016,26(7):139-142.
[2] Kurkar A,Elderwy AA,Awad SM,et al.Hyperuricemia:A possible cause of hemospermia[J].Urology,2014,84(3):609-612.
[3] 刘涛.薛建国教授辨证论治血精症验案举隅[J].河北中医,2014,36(3):331-332.
[4] Zargooshi J,Nourizad S,Vaziri S,et al.Hemospermia:Long-term outcome in 165 patients[J].Int J Impot Res,2014,26(3):83-86.
[5] 唐松喜,周辉良,丁一朗,等.经尿道精囊镜技术治疗顽固性血精与射精管梗阻性无精症、少弱精症的临床效果[J].中华医学杂志,2016,96(36):2872-2875.
[6] Badawy AA,Abdelhafez AA,Abuzeid AM.Finasteride for treatment of refractory hemospermia:Prospective placebo-controlled study[J].Int Urol Nephrol,2012,44(2):371-375.
[7] 蒋小强.精囊镜技术在血精症诊治中的应用价值[J].中国基层医药,2014,21(4):506-507.
[8] 朱海鹏,史校学,酒涛,等.前列欣胶囊治疗Ⅲ型前列腺炎合并血精症的临床观察[J].中国男科学杂志,2014,28(6):59-60,64.
[9] Abdelkhalek MA,Abdelshafy M,Elhelaly HA,et al.Hemospermia after transrectal ultrasound (TRUS)-guided prostatic biopsy:A prospective study[J].J Egypt Soc Parasitol,2012,42(1):63-70.
[10] 刘磊,赵调调.微创手术治疗血精症对性功能的影响观察分析[J].中国性科学,2017,26(7):24-27.
[11] Papoutsoglou N,Burger M,Riedmiller H.Persistent painless hemospermia due to metastatic melanoma of the right seminal vesicle[J].BMC Urol,2013(13):43.
[12] 王养民,郭秀全,张惠芳,等.精囊镜血精诊治29例并文献复习[J].国际泌尿系统杂志,2014,34(2):193-196.
[13] Avargues A,Rogel R,Sánchez-Nevárez I,et al.Long-standing hemospermia in a patient with megacava associated to a circumaortic renal vein[J].Urol Ann,2015,7(3):405-407.
[14] 聂欢,高强利,陈磊,等.经尿道腔镜技术治疗精囊腺疾病所致血精症的临床研究[J].微创泌尿外科杂志,2016,5(6):367-370.
[15] 董超雄,李虎.精囊镜治疗血精100例的临床疗效分析[J].中国性科学,2016,25(2):5-7.
[16] 蒙有轩,王晓平,廖君娟,等.经尿道输尿管镜下精囊镜检术治疗血精症的护理[J].医学信息,2014(14):387-388.
[17] Turner CE,Walbornn SR,Blanchard TL,et al.The effect of two levels of hemospermia on stallion fertility[J].Theriogenology,2016,86(6):1399-1402.
[18] 张卫星,秦帅锋,王朝亮,等.经尿道精囊腺镜下精阜内切开术治疗射精管梗阻及血精症[J].河南医学研究,2017,26(5):772-774.
[2] Kurkar A,Elderwy AA,Awad SM,et al.Hyperuricemia:A possible cause of hemospermia[J].Urology,2014,84(3):609-612.
[3] 刘涛.薛建国教授辨证论治血精症验案举隅[J].河北中医,2014,36(3):331-332.
[4] Zargooshi J,Nourizad S,Vaziri S,et al.Hemospermia:Long-term outcome in 165 patients[J].Int J Impot Res,2014,26(3):83-86.
[5] 唐松喜,周辉良,丁一朗,等.经尿道精囊镜技术治疗顽固性血精与射精管梗阻性无精症、少弱精症的临床效果[J].中华医学杂志,2016,96(36):2872-2875.
[6] Badawy AA,Abdelhafez AA,Abuzeid AM.Finasteride for treatment of refractory hemospermia:Prospective placebo-controlled study[J].Int Urol Nephrol,2012,44(2):371-375.
[7] 蒋小强.精囊镜技术在血精症诊治中的应用价值[J].中国基层医药,2014,21(4):506-507.
[8] 朱海鹏,史校学,酒涛,等.前列欣胶囊治疗Ⅲ型前列腺炎合并血精症的临床观察[J].中国男科学杂志,2014,28(6):59-60,64.
[9] Abdelkhalek MA,Abdelshafy M,Elhelaly HA,et al.Hemospermia after transrectal ultrasound (TRUS)-guided prostatic biopsy:A prospective study[J].J Egypt Soc Parasitol,2012,42(1):63-70.
[10] 刘磊,赵调调.微创手术治疗血精症对性功能的影响观察分析[J].中国性科学,2017,26(7):24-27.
[11] Papoutsoglou N,Burger M,Riedmiller H.Persistent painless hemospermia due to metastatic melanoma of the right seminal vesicle[J].BMC Urol,2013(13):43.
[12] 王养民,郭秀全,张惠芳,等.精囊镜血精诊治29例并文献复习[J].国际泌尿系统杂志,2014,34(2):193-196.
[13] Avargues A,Rogel R,Sánchez-Nevárez I,et al.Long-standing hemospermia in a patient with megacava associated to a circumaortic renal vein[J].Urol Ann,2015,7(3):405-407.
[14] 聂欢,高强利,陈磊,等.经尿道腔镜技术治疗精囊腺疾病所致血精症的临床研究[J].微创泌尿外科杂志,2016,5(6):367-370.
[15] 董超雄,李虎.精囊镜治疗血精100例的临床疗效分析[J].中国性科学,2016,25(2):5-7.
[16] 蒙有轩,王晓平,廖君娟,等.经尿道输尿管镜下精囊镜检术治疗血精症的护理[J].医学信息,2014(14):387-388.
[17] Turner CE,Walbornn SR,Blanchard TL,et al.The effect of two levels of hemospermia on stallion fertility[J].Theriogenology,2016,86(6):1399-1402.
[18] 张卫星,秦帅锋,王朝亮,等.经尿道精囊腺镜下精阜内切开术治疗射精管梗阻及血精症[J].河南医学研究,2017,26(5):772-774.