外环下显微外科精索静脉结扎术对精索静脉曲张患者精液质量的影响  

Impact on semen quality of varicocele patients with spermatic vein ligation under the outer ring microsurgery

作　　者：符红霞[1] 梁培育[1] 周治彦[1] 

机构地区：[1]海南医学院附属医院泌尿外科,海口570102

出　　处：《中国性科学》2016年第8期10-12,共3页Chinese Journal of Human Sexuality

基　　金：2014年度海南省卫计委卫生计生行业科研项目(14A210271)

摘　　要：目的:探讨外环下显微外科精索静脉结扎术对精索静脉曲张患者精液质量的影响,并观察和分析其安全性。方法:选择本院2012年10月至2014年3月精索静脉曲张患者104例,根据手术方法分为对照组51例和观察组53例,对照组患者采用腹腔镜下精索静脉结扎术,观察组患者采用外环下显微外科精索静脉结扎术。记录两组患者手术时间、出血量、术后住院天数,检测治疗前后精液质量及畸形率,观察术后并发症及复发状况。结果:观察组出血量和住院时间分别为(24.58±4.93)m L和(5.13±1.24)d,均低于对照组,差异有统计学意义(P<0.05);观察组患者治疗后精子数量、精子活力和精子活动率分别为(43.76±7.22)×106/m L、(48.66±5.93)%和(55.28±7.50)%,均高于对照组治疗后(34.53±5.28)×106/m L、(37.83±6.36)%和(52.15±7.12)%,差异具有统计学意义(P<0.05)。观察组患者治疗后精子畸形率为(12.42±3.86)%,低于对照组治疗后(16.21±5.08)%,差异具有统计学意义(P<0.05)。观察组患者不良反应及复发总计4例(7.55%),低于对照组10例(19.61%),差异具有统计学意义(P<0.05)。结论:外环下显微镜精索静脉结扎术创伤小、恢复较快,能够显著提高患者精子数量和质量,术中可有效保护睾丸动脉及淋巴管,减少术后并发症及复发率。Objectives： To explore the impact on semen quality of varicocele patients with spermatic vein ligation under the outer ring microsurgery,and to observe and analyze its security. Methods： 104 varicocele patients were selected in the hospital from October in 2012 to March in 2014 and according to the operation method,were divided into the control group（ 51 cases） and the observation group（ 53 cases）. The control group was treatedby laparoscopic ligation of spermatic vein,while the observation group was treated by microsurgery under the outer ring ligation of spermatic vein. The operation time,blood loss,postoperative hospitalization time of two groups was recorded; the semen quality and malformation rate before and after the treatment was detected; the postoperative complications and recurrence was observed. Results： The blood loss and hospitalization time of the observation group respectively were（ 24. 58 ± 4. 93） ml and（ 5. 13 ± 1. 24） d,lower than the control group,with statistically significant difference（ P〈0. 05）. The sperm amount,sperm motility and sperm activity respectively of the observation group after treatment were（ 43. 76 ± 7. 22） × 106/ ml,（ 48. 66 ± 5. 93） % and（ 55. 28 ± 7. 50） %,higher than the control group（ 34. 53 ± 5. 28） × 106/ ml,（ 37. 83 ± 6. 36） % and（ 52. 15 ± 7. 12） %,with statistically significant difference（ P〈0. 05）. The sperm malformation rate of the observation group after treatment was（ 12. 42± 3. 86） %,lower than the control group（ 16. 21 ± 5. 08） %,with statistically significant difference（ P〈0. 05）.The total adverse reaction and recurrence in the observation group were 4 cases and 7. 55%,lower than the control group（ 10 cases,19. 61%）,with statistically significant difference（ P〈0. 05）. Conclusions： For outer ring ligation of spermatic vein under the microscope,it causes little injury and pain with rapid recovery,which can also significantly improve the sperm count and quality. During

关 键 词：显微外科 精索静脉结扎术 精索静脉曲张 精液质量 

分 类 号：R697.24[医药卫生—泌尿科学]