经直肠超声在精囊炎病程判定及治疗策略选择中的应用

目的探讨经直肠超声在精囊炎病程判定及治疗策略选择中的应用价值。方法回顾性分析因血精就诊于我院门诊，诊断为精囊炎并接受治疗及随访的患者临床资料，所有患者均行经直肠超声检查，检查由同一医师完成，分析患者的影像学特点并以此作为治疗策略选择的重要依据。结果本组共118例患者，超声表现分为二类：第一类（78例）为双侧精囊均增大，回声普遍减低，精囊内可见扩张管状暗区；第二类（30例）为双侧精囊腺大小正常，回声不均；第三类（10例）为双侧精囊大小正常，内可见钙化斑或射精管管壁钙化。此三类表现分别与急性精囊炎或慢性精囊炎急性发作、慢性精囊炎及病程超过10年的慢性精囊炎患者的经直肠超声表现良好相关，符合率均大于90％。且我们根据超声表现进行治疗策略的选择，若处于急性期则以抗感染保守治疗为主，若发现精囊钙化或结石则以精囊镜检查治疗为主，取得了满意的疗效。结论以精囊炎患者的经直肠超声表现来判定其所处病程并以此选择其治疗策略是可靠、方便及有效的。

The value of transrectal ultrasound in judging the course of spermatocystitis and determining the therapeutic schedule

Objectives To analyze the value of transrectal ultrasound （TRUS） in judging the course of spermatocystitis and determining the therapeutic strategy. Methods The transrectal ultrasound results of 118 patients which were diagnosed spermatocystitis with hemospermia in outpatient service with following therapy during June of 2008 to February of 2012 were reviewed. Results The ultrasonic manifestations of 118 patients who were diagnosed spermatocystitis can be divided into three categories. The first class （78 cases）： patients showed the increased volume of seminal vesicle, lower echo, and dilated tubular dark areas. The second class （30 cases）： the bilateral seminal vesicle size were normal following with uneven echo. The third class （10 cases）： the volume of bilateral seminal vesicle were normal, and calcification spots or ejaculation tube calcification could be found. The three ultrasonic manifestations were respectively correlated with acute spermatocystitis or acute attack stage of chronic spermatocystitis, chronic spermatocystitis , the chronic spermatocystitis with disease course for more than l0 years. The coincidence rate is greater than 90%. The therapy strategies were chosen according to the ultrasound manifestations. Conservative therapy and anti-infection were chosen to treat acute spermatocystitis, and transurethral seminal vesiculoscopy was chosen to treat chronic or calcificated spermatocystitis. The curative effect was satisfying. Conclusions To determine the stages of disease course and then to choose the treatment strategy according to transrectal ultrasound findings in patients with spermatocystitis was reliable,convenient and effective.