精囊镜治疗顽固性血精伴精囊结石的效果及对血清IgA、IgG、IgM水平的影响

杨晓伟 杨雪健 王雷雨 刘豪 邓鑫

【摘要】 目的：探讨精囊镜治疗顽固性血精伴精囊结石的效果及对血清IgA、IgG、IgM水平的影响。方法：选取2015年5月-2020年6月在本院診治的66例顽固性血精伴精囊结石患者作为研究对象，根据随机数字表法将患者分为精囊镜组与对照组，每组33例。精囊镜组给予经尿道精囊镜治疗，对照组给予超声引导下精囊穿刺置管治疗。术后1个月比较两组疗效和并发症，术前1 d与术后1个月采用本院自制量表对两组进行症状评分并比较，比较两组术前1 d与术后1个月血清IgA、IgG、IgM含量。结果：精囊镜组术后1个月总有效率为97.0%，高于对照组的78.8%（P<0.05）。精囊镜组术后1个月直肠损伤、尿路感染、逆行射精、尿失禁等并发症发生率为6.1%，低于对照组的27.3%（P<0.05）。两组术后1个月临床症状评分均低于术前1 d，且精囊镜组低于对照组，差异均有统计学意义（P<0.05）。两组术后1个月血清IgA、IgG、IgM含量均高于术前1 d，且精囊镜组均高于对照组（P<0.05）。结论：精囊镜治疗顽固性血精伴精囊结石能提高血清IgA、IgG、IgM含量，改善临床症状，提高治疗效果，减少并发症的发生。

【关键词】 精囊镜 顽固性血精 精囊结石 免疫功能

Effect of Seminal Vesiculoscope in the Treatment of Intractable Hematospermia with Seminal Vesicle Stones and Its influence on Levels of Serum IgA， IgG and IgM/YANG Xiaowei， YANG Xuejian， WANG Leiyu， LIU Hao， DENG Xin. //Medical Innovation of China， 2021， 18（27）： 0-025

[Abstract] Objective： To investigate the effect of seminal vesiculoscope in the treatment of intractable hematospermia with seminal vesicle stones and its influence on the levels of serum IgA， IgG and IgM. Method： A total of 66 patients with intractable hematospermia with seminal vesicle stones diagnosed and treated in our hospital from May 2015 to June 2020 were selected as the research objects， they were divided into the seminal vesiculoscope group and the control group according to the random number table method， 33 cases in each group. The seminal vesiculoscope group was given transurethral seminal vesiculoscope treatment， the control group was given ultrasound-guided seminal vesicle puncture and catheterization treatment. At 1 month after surgery， the effects and complications of two groups were compared， at 1 d before surgery and 1 month after surgery， symptom scores of the two groups were evaluated by the self-made scale of our hospital 1 day before surgery and 1 month after surgery， the scores were compared， the levels of serum IgA， IgG and IgM of two groups at 1 d before surgery and 1 month after surgery were compared. Result： The total effective rates in the seminal vesiculoscopy group at 1 month after surgery were 97.0%， which was higher than 78.8% in the control group （P<0.05）. The incidence of complications such as rectal injury， urinary tract infection， retrograde ejaculation， and urinary incontinence in the seminal vesiculoscopy group at 1 month after surgery were 6.1%， which was lower than 27.3% in the control group （P<0.05）. The clinical symptom scores of two groups at 1 month after surgery were lower than those of preoperative 1 d and the seminal vesiclescopy group was lower than that of the control group （P<0.05）. The levels of serum IgA， IgG， and IgM in two groups at 1 month after surgery higher than those of preoperative 1 d， and the seminal vesiclescopy group were higher than those of the control group （P<0.05）. Conclusion： Seminal vesiclescopy can increase the levels of serum IgA， IgG， IgM in patients with intractable hematospermia with seminal vesicle stones， improve clinical symptoms， improve therapeutic effects， and reduce complications.

[Key words] Seminal vesiclescopy Intractable hematospermia Seminal vesicle stones Immune function

First-author’s address： Suqian First People’s Hospital， Suqian 223800， China

doi：10.3969/j.issn.1674-4985.2021.27.006

精囊結石在泌尿外科中相对较少见，患者常因血精症状就诊[1]。该病在各个年龄段的男性中皆可发病，临床上可伴随下腹部隐痛，多为良性及自限性疾病，但部分患者因病情反复发作与久治不愈，可进展为顽固性血精，严重影响患者身心健康[2-3]。顽固性血精伴精囊结石的发生机制尚不明确，可能与自身免疫异常、病原体感染、神经内分泌、尿液返流、精神心理等因素有关，至今尚无明确而统一的治疗方案[4]。……