腹腔镜精索静脉高位结扎术中睾丸动脉结扎与否对睾丸影响的研究  

Study on the the effect of testicular artery ligation or not in laparoscopic high ligation of spermatic vein on testicular

作　　者：郭在柱[1] 刘志刚[1] 周曼恬[1] 黎明[1] 叶朝阳[1] 程祎[1] 李梅[1] 吴志荣[1] 莫永轩[1] 李杰[1] 

机构地区：[1]广东省东莞市太平人民医院泌尿外科,广东东莞523900

出　　处：《中国当代医药》2012年第31期11-12,15,共3页China Modern Medicine

基　　金：广东省东莞市科技计划项目(200910515000407)

摘　　要：目的探讨临床应用腹腔镜精索静脉高位结扎术中睾丸动脉结扎后对患者的睾丸是否有影响。方法选取20例临床应用腹腔镜精索静脉高位结扎术中行精索内静脉及睾丸动脉集束结扎患者作为观察组,另外选取临床应用腹腔镜单纯进行结扎精索内静脉患者20例作为对照组,在术后半年、1年以及2年时随访,对比分析两组患者于术前以及术后在睾丸血供(以测量睾丸的动脉最大血流速度为指标)、睾丸大小及生精功能变化,并观察并发症的发生情况。结果通过术后2年的临床观察,发现观察组的睾丸动脉血流速度与术前比较数值相近,手术前后间的差异无统计学意义(P>0.05)。观察组睾丸容积术后未见缩小(P>0.05)。此外,两组患者经过手术治疗后精液的质量均得到明显改善,随访发现,观察组有1例患者睾丸鞘膜有少量积液,对照组未见有并发症,两组对比,差异无统计学意义(P>0.05)。结论腹腔镜精索静脉高位结扎术中集束结扎睾丸动脉对睾丸的动脉血供及生精功能无明显的影响,也未见睾丸萎缩情况出现。临床上该项操作安全可行。Objective To discuss the effect of testicular artery ligation or not in laparoscopic high ligation of spermatic vein on testicular. Methods Twenty patients treated by spermatic vein and testicular artery cluster ligation in laparoscopic high ligation of spermatic vein were selected as observation group in this study, 20 patients with simple ligation of the inside spermatic vein treated by clinical application of laparoscopic were selected as control group, they were followed up after operation of six months, a year and two years, testicular blood supply （according to the index of measuring the testicular artery blood flow velocity）, testicular size and raw spermatogenic function changes of two groups in the preoperative and postoperative were compared and analyzed, and the incidence of complications were observed. Results The postoperative clinical observation for two years, the values of testicular artery blood flow velocity and observation group was similar com- pared with before operation, there was no significant difference between before and after surgery （P 〉 0.05）. Testicular vol ume of observation group had no narrowing （P 〉 0.05）. In addition, the semen quality of two groups were significantly im- proved after surgical treatment, there was one patient with a small amount of effusion in the tunica vaginalis were found in observation group in the follow-up, and control group had no complications, there was no significant difference between two groups （P 〉 0.05）. Conclusion Spermatie vein and testicular artery cluster ligation in laparoscopic high ligation of sper- matic vein has no significant impact to the testicular artery ligation cluster arterial blood supply to the testis and the sper- matogenie function without testicular atrophy. So the operation is safe and feasible.

关 键 词：精索静脉高位结扎术 睾丸动脉 睾丸生精功能 

分 类 号：R69[医药卫生—泌尿科学]