显微镜下精索静脉结扎术对青年原发性精索静脉曲张患者的安全性评价  

Evaluation of safety of spermatic vein ligation under microscope for young patients with primary varicocele

作　　者：翁迈[1] 刘建春[1] 靳继韬 于华[1] 凡航 刘马豆 周晶[2] 

机构地区：[1]武警北京总队第二医院肾病科,100037 [2]武警总医院首保临床部,北京100039

出　　处：《武警医学》2016年第5期476-478,481,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨显微镜下精索静脉结扎术对青年原发性精索静脉曲张患者的安全性。方法 80例在我院确诊为原发性精索静脉曲张患者,随机分为观察组和对照组各40例,观察组接受显微镜下精索静脉结扎术,对照组接受经后腹膜精索静脉结扎术,比较两组的手术情况、精子质量、并发症情况及复发情况。结果观察组和对照组相比,术后卧床时间[(1.05±0.45)d vs(5.36±0.72)d],差异有统计学意义(P<0.05)、住院总时间[(6.12±0.44)d vs(7.92±0.56)d]明显缩短,差异有统计学意义(P<0.05),NRS疼痛评分[(1.03±0.35)vs(2.75±0.48)]明显下降(P<0.05);术后3个月,观察组与对照组相比,精子密度[(68.25±7.72)×106/ml vs(54.36±5.45)×106/ml,P<0.05]、精子活动力a级[(25.36±3.12)%vs(20.12±2.25)%],均明显升高(P<0.05);观察组术后静脉曲张复发率明显低于对照组(P<0.05)。结论显微镜下精索静脉结扎术有助于减小手术创伤,促进术后恢复,提高精子质量,预防远期复发。Objective To study the safety of spermatic vein ligation under microscope for young patients with primary varicocele. Methods 80 primary varicocele patients in this hospital from June 2012 to December 2014 were enrolled for study and randomly divided into study group and control group. The study group received spermatic vein ligation under the microscope,the control patients received retroperitoneal spermatic vein ligation surgery. Then surgery condition,sperm quality,complications and recurrence between the two groups were compared. Results Operation： in the study group,postoperative bed time was [（ 1. 05 ± 0. 45） d vs（ 5. 36 ±0. 72） d,P〈0. 05],hospitalization time was[（ 6. 12 ± 0. 44） d vs（ 7. 92 ± 0. 56） d,P〈0. 05],NRS pain score [（ 1. 03 ± 0. 35） vs（ 2. 75 ± 0. 48）,P〈0. 05]were significantly lower than in the control group,operation time was significantly longer than in the control group. Semen quality： 3 months after surgery,in the study group,sperm density and sperm activitywer grade A,forward sperm activity rate was significantly higher than in the control group. Sperm movement ability： 3 months after surgery,in the study group,sperm speeding ahead,straight line movement,and curve movement were significantly higher than in the control group. Recurrence rate： in the study group. varicose vein recurrence rate 0. 00% was significantly lower than in the control group 12. 50%（ P〈0. 05）.Conclusions Spermatic vein ligation under a microscope helps to reduce surgical trauma,promotes postoperative recovery,improves sperm quality,and prevents long-term relapse.

关 键 词：原发性精索静脉曲张 精索静脉结扎术 显微镜 精子质量 

分 类 号：R697.24[医药卫生—泌尿科学]