三种手术方法治疗精索静脉曲张的疗效比较  

Comparison of Three Surgical Methods for Treatment of Varicocele

作　　者：梁春[1] 詹晓明[1] 罗裕春 

机构地区：[1]遂溪县人民医院泌尿外科,广东遂溪524300

出　　处：《实用临床医学（江西）》2014年第4期54-55,57,共3页Practical Clinical Medicine

摘　　要：目的探讨3种不同手术方法治疗精索静脉曲张的临床效果。方法将90例精索经脉曲张的患者按照不同的手术方式分为3组:腹股沟组30例采用经腹股沟精索静脉结扎术治疗;显微手术组30例采用经腹股沟显微镜下手术治疗;腹膜后组30例采用经腹膜后小切口精索静脉结扎术治疗。比较3种手术方式的临床效果。结果 3组手术在单侧手术时间以及术后住院时间方面比较,差异无统计学意义(P>0.05);术后3组患者的精液质量较之术前明显提高(P<0.05),显微手术组的改善率明显高于其他2组(P<0.05),显微手术组的复发率也明显低于其余2组(P<0.05),各组术后早期均未发生阴囊水肿、睾丸鞘膜积液等并发症。结论显微手术在精液质量改善、预防术后复发方面明显优于经腹股沟和腹膜后手术,是治疗精索静脉曲张的安全、有效、简单的手术方式。Objective To observe the clinical efficacies of three surgical methods for the treatment of varicocele. Methods Ninety patients with varicocele were treated with inguinal spermatic vein ligation （groin group, n=30）, inguinal microscopic surgery （microscopic surgery group, n=30）, or retroperitoneal spermatic vein ligation （retroperitoneal group, n=30）. The clinical efficacies were compared among the three groups. Results There were no significant differences in unilateral operation time and hospital stay among the three groups （P〉0.05）. After treatment, semen quality was obviously improved in all the three groups （P〈0.05）. Compared with groin group or retroperitoneal group, inguin-al microscopic surgery significantly increased the improvement rate and markedly decreased recurrence rate（P〈0.05）. No scrotal edema, tunica vaginalis hydrocele and other complications occurred during the early postoperative period in all patients. Conclusion Microsurgery is superior to inguinal surgery and retroperitoneal surgery for improving semen quality and preventing postoperative recurrence. Therefore, microsurgery is a safe and effective procedure for the treatment of varicocele.

关 键 词：精索静脉曲张 腹股沟 腹膜后 显微手术 

分 类 号：R697.24[医药卫生—泌尿科学]