精索内动静脉同时结扎治疗精索静脉曲张的临床研究  

Spermatic vein and artery ligation for varicocele

作　　者：陈国强[1] 蒋冬非[1] 陈晨[1] 唐秀泉[1] 刘湘彬[1] 白文俊[2] 

机构地区：[1]大庆油田总医院泌尿外科,黑龙江大庆163001 [2]北京大学人民医院泌尿外科,北京100044

出　　处：《中华男科学杂志》2010年第2期154-157,共4页National Journal of Andrology

摘　　要：目的:探讨精索内动静脉同时结扎治疗精索静脉曲张对睾丸血流动力学、生精功能及睾丸体积的影响。方法:将精索静脉曲张患者随机分为精索内动脉结扎组与保留组,结扎组46例,保留组42例;术前和术后6个月血流显像测量睾丸血流动力学参数及体积,并行精液常规检查。结果:两组睾丸动脉(TA)收缩期最大血流速度(Vmax)、舒张期最小血流速度(Vmin)、平均血流速度(Vmean)、包膜动脉(CA)Vmin手术前后差异无显著性(P>0.05),组间差异无显著性(P>0.05);精子密度、精子活率、精子活力术后均有明显改善(P<0.01),组间差异无显著性(P>0.05);睾丸体积手术前、后无明显改变(P>0.05)。结论:精索内动静脉同时结扎对睾丸血流动力学、生精功能及体积无不利影响,在无腹股沟区手术史的患者可行精索内动静脉集束结扎治疗精索静脉曲张。Objective：To assess the influence of spermatic vein and artery ligation on testicular hemodynamics,spermatogenesis and testis volume in varicocele patients.Methods：Eighty-eight varicocele patients were randomly divided into a spermatic vein and artery ligation（n=46） and a spermatic vein and artery preservation group（n=42）.The testicular hemodynamic parameters, testis volume and results of semen analyses were obtained before and 6 months after the surgery and compared between the two groups. Results：There were no significant differences in peak systolic velocity（Vmax）,end diastolic velocity（Vmin）,mean enveloped velocity （Vmean） and Vmin of the capsular artery（CA） either between the ligation and preservation groups（P〈0.05） or between pre- and post-operation（P〈0.05）.Sperm density,vitality and motility were significantly improved after surgery（P〈0.01）,with no significant differences between the two groups（P〈0.05）.No significant difference was found in the testis volume between the two groups before and after the operation（P〈0.05）.Conclusion：Spermatic vein and artery ligation in varicocelectomy does not affect the testicular hemodynamics,spermatogenesis and testis volume of varicocele patients.Both the spermatic vein and artery should be ligated when necessary.

关 键 词：精索静脉曲张 精索静脉结扎术 精索内动脉 血流动力学 睾丸 

分 类 号：R699[医药卫生—泌尿科学]