左肾静脉受压与精索静脉曲张术后复发关系的探讨  

Relationship between left renal vein compression phenomenon and left varicocele recurrence rate

作　　者：管日戬 李森[1] 王进[1] 张友朋[1] 程永彪[1] 曾汉青[1] 朱朝辉[1] GUAN Rijian LI Sen WANG Jin ZHANG Youpeng CHENG Yongbiao ZENG Hanqing ZHU Zhaohui(Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Chin)

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022

出　　处：《临床泌尿外科杂志》2017年第2期122-126,共5页Journal of Clinical Urology

摘　　要：目的:探讨左肾静脉受压现象对左侧精索静脉曲张的发生、术后疗效及复发率的影响。方法:回顾性分析2013年7月~2015年3月在我院就诊的520例左侧精索静脉曲张患者的临床资料。520例患者中,146例(28.1%)合并左肾静脉受压现象,排除11例失访者,将其余的135例列为研究组;另374例(71.9%)为单纯性精索静脉曲张患者,排除29例失访者,将其余的345例列为对照组。两组患者均行显微镜下精索静脉结扎术,并分析其术后的精液质量改善情况及复发率。结果:研究组精索静脉曲张直径高于对照组(P<0.05),术后复发率高于对照组(P<0.05);两组患者术后3个月精子浓度、PR级精子及PR+NP级精子百分率均较术前明显改善(P<0.05),但两组之间的差异无统计学意义(P>0.05);研究组术前术后左肾静脉受压程度未见明显加重(P>0.05)。结论:左肾静脉受压的解剖学改变可能是男性左侧精索静脉曲张发生的重要原因,且合并左肾静脉受压患者的精索静脉曲张直径高于单纯精索静脉曲张患者。轻度左肾静脉受压现象可能是左侧精索静脉曲张患者术后复发的又一重要因素。Objective：To study the relationship between left renal vein compression phenomenon and left varicocele postoperative recurrence rate.Method：From 2013 to 2015,a total of 520 patients with left varicocele were enrolled.In the 520 left varicocele patients,there were 146 patients have varicocele combined with left renal vein compression phenomenon（28.1%）.A total of 135 patients for varicocele combined with left renal vein compression phenomenon were enrolled in the study group,and 345 patients with only varicocele were enrolled in the control group.All the patients underwent microsurgical varicocelectomy.The semen routine analysis and the ultrasound of left renal vein were reviewed,and postoperative complications were observed.Result：We found that the left spermatic vein diameter and recurrence rate were significantly different in the study group compared with those of the control group.But in the postoperative complications,postoperative semen parameters were found no difference.What＇s more,all the two groups were showed significant improvement in the postoperative semen parameters.In addition,there were found no increase at the left renal vein compression level in the study group after operation.Conclusion：Our findings indicate that left renal vein compression phenomenon were found frequently in varicocele patients and should be considered as a possible cause of left varicocele.What＇s more,the left renal vein compression phenomenon may be another important influence factor in the postoperative recurrence rate for patients with varicocele.

关 键 词：精索静脉曲张 左肾静脉受压 显微镜下精索静脉结扎术 术后复发 

分 类 号：R697[医药卫生—泌尿科学]