双镜联合诊治尿道源性血精血尿的临床体会

发布时间：2018-06-04 05:45

本文选题：经尿道精囊镜 + 经尿道等离子电切镜　；参考：《中国微创外科杂志》2017年12期

【摘要】：目的探讨尿道源性血精血尿的临床特点及微创诊疗方法。方法回顾性分析2015年7月~2017年6月13例血精血尿患者的临床资料,年龄29~51岁,平均37.6岁,病史6个月~7年,中位数27个月。均有性生活后血精血尿,口服止血及抗感染药物等治疗效果不佳。尿常规、泌尿系彩超及CT等检查未见明显异常,行经尿道等离子双极电切镜、经尿道精囊镜双镜联合检查和治疗。结果手术均顺利完成,镜检显示13例均为尿道源性血精血尿,前列腺小囊及精囊未见异常,精阜周围及后尿道黏膜血管曲张,黏膜糜烂、渗血。均行经尿道等离子双极电切镜下黏膜电灼术,手术时间30~72 min,平均45 min。13例术后症状均消失,随访3~12个月,平均9个月,均未见复发。结论经尿道等离子双极电切镜、经尿道精囊镜双镜联合诊断和治疗尿道源性血精血尿安全,有效,微创。
[Abstract]:Objective to investigate the clinical features and minimally invasive diagnosis and treatment of urethral hematuria. Methods the clinical data of 13 patients with hematuria from July 2015 to June 2017 were retrospectively analyzed. The age was 29 to 51 years (mean 37.6 years). The history was 6 months to 7 years with a median of 27 months. After sexual life, blood essence hematuria, oral hemostasis and anti-infective drugs are not effective. There was no obvious abnormality in urography, urography and CT examination. The combined examination and treatment were performed by transurethral plasma bipolar endoscopy and seminal vesicle endoscopy. Results all the operations were completed successfully. The results of microscopic examination showed that 13 cases were hematuria of urethral origin, no abnormality of vesicle and seminal vesicle of prostate, varicose vessels of mucosa around caruncle and posterior urethra, mucosal erosion and blood leakage. All patients were treated with transurethral plasma bipolar electrocautery. The operative time was 30 ~ 72 minutes. The average postoperative symptoms disappeared in 45 min.13 patients. The follow-up period was 3 ~ 12 months (mean 9 months), and no recurrence was found. Conclusion it is safe, effective and minimally invasive to diagnose and treat urethral hematuria by transurethral plasma bipolar endoscopy and seminal vesicle.
【作者单位】：河南省人民医院泌尿外科郑州大学人民医院;
【基金】：河南省自然科学基金(162300410309) 河南省男科学基础与临床研究院士工作站基金(2016年)
【分类号】：R699

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