摘要
目的 探讨经前列腺小囊破壁入路精囊镜手术治疗精囊炎的临床效果.方法 回顾性收集2019年9月至2022年9月郑州大学第一附属医院收治的69例精囊炎患者的临床资料,根据手术方法的不同分为观察组(35例,经前列腺小囊破壁入路精囊镜手术)和对照组(34例,经射精管开口入路精囊镜手术).比较两组围手术期相关指标、术前和术后1个月时精囊体积、红细胞数量、尿动力学指标[最大尿流率(Qmax)、残余尿量(PVR)]、精浆生化指标,以及术后并发症发生情况和随访6个月时患者复发情况.结果 对照组手术时间长于观察组(P＜0.05);术后1个月,对照组精囊体积、红细胞数量高于观察组(P＜0.05);术后1个月时,两组PVR水平均低于术前,Qmax水平均高于术前(P＜0.05);术后1个月时,两组精浆果糖、唾液酸水平均高于术前(P＜0.05);两组术后并发症总发生率比较,差异无统计学意义(P＞0.05);术后随访6个月时,对照组精囊炎患者复发率高于观察组(P＜0.05).结论 经前列腺小囊破壁入路精囊镜手术治疗精囊炎的效果显著,可缩短患者手术时间,降低患者红细胞数量、精囊体积和术后复发率,改善患者尿动力学指标和精浆生化指标,且不会增加并发症.
Abstract
Objective To explore the clinical effect of seminal vesicular endoscopic surgery through the rupture of prostatic vesicles for the treatment of seminal vesiculitis.Methods Clinical data of 69 patients with seminal vesiculitis admitted to the First Affiliated Hospital of Zhengzhou University from September 2019 to September 2022 were retrospectively collected.According to the different surgical methods,the patients were divided into an observation group(35 cases,underwent seminal vesicular endoscopic surgery via the prostatic vesicle rupture approach)and a control group(34 cases,underwent seminal vesicular endoscopic surgery via the ejaculatory duct opening approach).The perioperative relevant indexes,seminal vesicle volume,red blood cell count,urodynamic indexes[maximum flow rate(Qmax),post-voided volume residua(PVR)],seminal plasma biochemical indicators before and 1 month after surgery were compared between the two groups,as well as the occurrence of postoperative complications and the recurrence of patients at 6 months of follow-up.Results The surgical time in the control group was longer than that in the observation group(P＜0.05).One month after surgery,the volume of seminal vesicles and the number of red blood cells in the control group were higher than those in the observation group(P＜0.05).At one month after surgery,the PVR levels in both groups were lower than before surgery,and the Qmax levels were higher than before surgery(P＜0.05).At one month after surgery,the levels of fructose and sialic acid in the seminal plasma of both groups were higher than before surgery(P＜0.05).Comparison of total incidence of postoperative complications between two groups,there was no significant difference(P＞0.05).At a postoperative follow-up of 6 months,the recurrence rate of patients with seminal vesiculitis in the control group was higher than that in the observation group(P＜0.05).Conclusion The treatment of seminal vesiculitis through transurethral vesicular puncture and seminal vesicular endoscopic surgery has a significant effect,which can shorten the surgical time of patients,reduce the number of red blood cells,seminal vesicle volume,and postoperative recurrence rate,improve the urodynamic and seminal plasma biochemical indicators of patients,and do not increase complications.
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