精索静脉显微手术对改善精索静脉曲张患者精子质量的效果分析  

Effects of outer spermatic vein microanatomy ligation on varicocele patients' sperm quality

作　　者：刘刚[1] 朝鲁[1] 陈锐[1] 崔志刚[1] 刘小勇[1] 宋笑童 刘淳[1] 向瑜[1] 韩文涛[1] 

机构地区：[1]解放军第306医院泌尿外科,北京100101

出　　处：《现代泌尿外科杂志》2015年第10期726-729,共4页Journal of Modern Urology

摘　　要：目的探讨精索静脉曲张患者应用经外环下精索静脉显微结扎术(MV)的临床效果及对精子质量的影响。方法选取解放军第306医院2011年1月至2014年12月收治的精索静脉曲张患者中仅左侧病变的241例为研究对象,116例接受经外环下精索静脉显微结扎术治疗患者为观察组,125例接受经腹膜后结扎精索血管(Palomo)术治疗患者为对照组,观察两组患者手术及住院情况,精子质量变化情况及手术安全性。结果观察组患者同对照组比较,手术时间明显较长[(95.31±9.63)vs.(25.12±5.11),P<0.05],术后住院时间较短[(3.19±1.03)vs.(7.32±1.87),P<0.05],术中出血量较少[(3.75±1.32)vs.(11.49±1.76),P<0.05];两组患者术前精液相关指标均无明显差异(P>0.05),术后6个月均有明显改善,但观察组精子质量明显优于对照组(P<0.05);观察组并发症发生率为5.17%,同对照组16.80%比较,明显较低(P<0.05)。结论在精索静脉曲张治疗中应用经外环下精索静脉显微结扎术,创伤小、恢复快、可更好地改善精子质量、具有较高安全性,值得推广。Objective To investigate the clinical efficacy of outer spermatic vein microanatomy ligation in treating varicocele and its effects on sperm quality.Methods A total of 241 varicocele patients treated in our hospital during Mar.2012 and Jan.2015 were divided into 2 groups：the observation group（n=116）,who were treated with outer spermatic vein under microanatomy ligation treatment,and control group（n=125）,who were treated with retroperitoneal ligation of the spermatic vessels.The paraoperative parameters and sperm quality changes were observed.Results Compared with the control group,the observation group had longer operation time（95.31±9.63 vs.25.12±5.21,P〈0.05）,shorter postoperative hospital stay（3.19±1.03 vs.7.32±1.87,P〈0.05）,and less intraoperative blood loss（3.75±1.32 vs.11.49±1.76,P〈0.05）.As to semen quality,there was no difference between the two groups,and both groups improved after operation,but the observation group had much better semen quality 6 months after operation（P〈0.05）.The incidence of complications was 5.17% of the observation group,which was much lower than that of the control group（16.8%）（P〈0.05）.Conclusion Outer spermatic vein microanatomy ligation to treat varicocele has less surgical trauma and quick recovery,and can significantly improve sperm quality.Therefore,it should be widely applied in clinical practice.

关 键 词：精索静脉曲张 显微手术 精子质量 

分 类 号：R699.8[医药卫生—泌尿科学]