目的 研究精囊镜对精囊腺梗阻引发的血精症患者的疗效及应用安全性并予以分析,目的 在于为精囊腺梗阻引发的血精症患者寻求一种积极有效的治疗方式。方法 选取2017年4月—2022年6月成武县人民医院收治的82例精囊腺梗阻引发的血精症患者纳入研究。按照电脑随机数字表法分成手术组和保守组,每组各41例。保守组实施综合保守治疗,手术组则实施经尿道精囊镜手术治疗。比较两组临床疗效,治疗前后性功能变化情况,治疗前后精液红细胞、白细胞含量,并发症发生情况。结果 手术组治疗总有效率高于保守组（P<0.05）。治疗后手术组及保守组勃起功能评分（IIEF-5）与射精功能评分（CIPE）相较于治疗前均明显提高,且手术组高于保守组（均P<0.05）。治疗后手术组及保守组的精液红细胞、白细胞计数均少于治疗前,且手术组少于保守组（均P<0.05）。手术组与保守组在尿道狭窄、尿失禁及感染发生率方面对比均不明显（均P>0.05）。结论 精囊镜的应用可显著提高精囊腺梗阻引发的血精症患者临床疗效,提高患者的性功能,同时减少精液红细胞、白细胞计数,术后并发症发生风险较小,安全性较佳。
Objective To study the efficacy and safety of seminal vesiculoscopy in patients with hematospermia induced by seminal vesicle gland obstruction, and to find a positive and effective treatment for the disease. Methods A total of 82 patients with hematospermia induced by seminal vesicle gland obstruction admitted to Chengwu County People's Hospital from April 2017 to June 2022 were included in the study. According to the method of computer random number table, the patients were divided into an operation group and a conservative group, 41 cases in each group. The conservative group received comprehensive conservative treatment, while the operation group received transurethral seminal vesiculoscopy. The clinical efficacy, sexual function changes, red blood cell (RBC) and white blood cell (WBC) contents in semen before and after treatment, and complications were compared between the two groups. Results The total effective rate of the operation group was higher than that of the conservative group (P<0.05). The International Index of Erectile Function-5 (IIEF-5) and Chinese Index of Premature Ejaculation (CIPE) scores of the operation group and the conservative group after treatment were significantly higher than those before treatment, and the scores of the operation group were higher than those of the conservative group (P<0.05). After treatment,the counts of RBC and WBC in the operation group and the conservative group were all lower than those before treatment, and the counts in the operation group were lower than those in the conservative group (P<0.05). There were no significant differences in urethral stricture, urinary incontinence, and infection rate between the operation group and the conservative group (P>0.05). Conclusion The application of seminal vesiculoscopy can significantly improve the clinical efficacy of hematospermia patients induced by seminal vesicle gland obstruction, improve sexual function, and reduce the counts of semen RBC and WBC, with a small postoperative complication risk and high safety.
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