改良Palomo术与静脉栓塞术治疗精索静脉曲张的疗效分析  

Comparative Analysis of modified Palomo procedure varicocele ligation and interventional embolization therapy of varieoeele

作　　者：蒲春林[1] 王英刚[1] 张培新[1] 马合苏提[1] 闵立贵[1] 张建军[1] 唐泽天[1] 阿布都热合曼 南玉奎[1] 靳宏勇[1] 

机构地区：[1]新疆维吾尔自治区人民医院泌尿男科,乌鲁木齐830001

出　　处：《国际泌尿系统杂志》2011年第5期627-630,共4页International Journal of Urology and Nephrology

摘　　要：目的通过改良Palomo术与介入栓塞治疗精索静脉曲张的临床对比，探讨两者之间的优劣性。方法234例患者随机分为两组，改良Palomo术高位结扎组117例，介入栓塞组117例，随访3—6个月，分别就手术时间、术中出血、住院时间、医疗费用方面、并发症发生率、复发率等方面进行比较。结果两组病例对比观察，手术时间分别为31±6min和41±5rain，术中出血量分别为12．68±4．5ml和3．72±2．8ml，住院时间分别为8．2±4．5d和6．1±2．4d，医疗费用分别为7634±1293元和10603±1448元；两组在手术时间、术中出血、住院时间、医疗费用方面有差异性（P〈0．05），在并发症发生率、术后复发率方面无显著性差异（p〉0．05），在术前、术后精液质量对比有显著性差异（p〈0．01），两组患者均在治疗后精液质量显著提高，但两组间治疗效果无显著差异（p〉0．05）。结论与静脉栓塞治疗相比，改良Palomo术中出血较多，住院时间长，但手术时间短，医疗费用低，是首选手术方式；静脉栓塞治疗可能出现严重的并发症，需慎用，较适合复发者。Objectives To investigate the clinical effect of different treatments of varicocele （Vc）. Methods 234 cases were divided into two groups, modified Palomo procedure varicocele ligation group （ 117 cases） and interventional embolization therapy of varicocele group （ 117 cases）. All the patients they were followed up for three years post operation. The treatment procedure, operation effect and complications ect were compared between two groups. Results The operation times were 31 ±6 min and 41 ±5 min , the intraoporative hemorrhage were 12.68 ± 4.5 ml and 3.72 ±2.8 ml, the hospitalization time were 8.2 ± 4.5 d and 6.1 ± 2.4d , the medical cost were RMB 7634± 1293 and 10603 ± 1448 , respectively, in the retroperitoneal highligation and interventional embolization therapy of varieocele groups （ p 〈 0.05 ）. There was no statistic difference in complication rates , the recurrence rates between two groups（ p 〉 0.05 ）. All the 2 groups before and after treatment were statically significant differenees in semen quality （ p 〈0.01 ）. Semen quality were improved after therapy in all 2 groups. But the results of the 2 threpy methods has no significant difference（ p 〉 0.05 ）. Conclusions Modified Palomo procedure varicocele ligation is the first choice for patients with varieocele. Vein embolism is recommended for reeurrent and bilateral varieocele and should be used cautiously for its severe complications.

关 键 词：精索静脉曲张 栓塞 治疗性 

分 类 号：R699[医药卫生—泌尿科学]