显微镜下两种入路治疗精索静脉曲张引起的阴囊疼痛疗效对比  

Effectiveness comparison between inguinal and subinguinal surgical approaches of microscopic varicocelectomy for painful varicocele

作　　者：苏剑锋 张炎[2] 杨晓健[2] 张浩[3] Su Jianfeng Zhang Yan Yang Xiaojian Zhang Hao(Departmentof Urology, the Second Hospital of Nongken in Zhanjiang, Guangdong 524272, China Department of infertility and sexal medicine Department of Urology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China)

机构地区：[1]湛江农垦第二医院泌尿外科,广东524272 [2]中山大学附属第三医院不育与性医学科,广州510630 [3]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2017年第1期55-58,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的比较显微镜下经腹股沟途径与经腹股沟下途径两种精索静脉结扎手术方法治疗精索静脉曲张引起的阴囊不适或疼痛的疗效及手术时间。方法 2011年7月至2013年6月,中山大学附属第三医院收治以阴囊不适或疼痛为主诉的精索静脉曲张患者68例(81侧),患者均采用显微技术进行手术治疗,随机将患者分为两组,分别采用经腹股沟途径和经腹股沟下途径手术入路,采用视觉模拟评分法(VAS)评估患者术前、术后疼痛程度,术中记录患者手术时间,术后通过患者复诊及电话随访方式记录患者术后疼痛是否缓解、伤口是否不适、复发率和并发症的发生情况。结果显微镜下经腹股沟途径与经腹股沟下途径术后疼痛缓解率分别为94.1%(32/34)和97.1%(33/34),术后复发率分别为5.9%(2/34)和2.9%(1/34),阴囊水肿率分别为0%(0/34)和2.9%(1/34),睾丸萎缩率分别为0%(0/34)和0%(0/34),伤口不适率分别为14.7%(5/34)和5.9%(2/34),各组差异均无统计学意义。手术时间分别为(31±6)min和(36±8)min,差异有统计学意义(P<0.05)。结论显微镜下经腹股沟途径与经腹股沟下途径均为治疗精索静脉曲张引起的阴囊疼痛的有效方法,而经腹股沟途径手术耗时更短。Objective To compare the effectiveness and operative time between inguinal and subinguinal surgical approaches of microscopic varicocelectomy for painful varicocele. Sixty-eight patients with painful varicocele in the Third Affiliated Hospital of Sun Yat-sen University, between July 2011 and June 2013 were divided into 2 groups of inguinal and subinguinal microscopic varicocelectomy. Operative time was recorded. Painful release rate, postoperative uncomfortable rate, relapse rate and complications were followed up. Results The operative time of inguinal and subinguinal microscopic varicocelectomy were （31±6） min vs （36±8） min, （P〈0.05）. There was no sinificant difference of painful release rate（94.1% vs 97.1%, P=-1.000）, postoperative uncomfortable rate （14.7% vs 5.9%, P=0.427）, relapse rate（5.9% vs 2.9%, P=1.000）, scrotal edema （0% vs 2.9%, P=1.000） and testicular atrothy（0% vs 0%, P=1.000） between the 2 groups. Conclusion Inguinal and subinguinal microscopic varicocelectomy are both effective for painful varicocele treatment,and the time-consuming of coinguinal approach seems shorter.

关 键 词：精索静脉曲张 阴囊疼痛 经腹股沟途径 经腹股沟下途径 

分 类 号：R699.8[医药卫生—泌尿科学]