腹膜后精索内静脉高位结扎术治疗精索静脉曲张的临床研究  

Clinical study of high ligation of retroperitoneal spermatic vein for treatment of varicocele

作　　者：雷永东 刘小勇[2] 向宸辉[2] LEI Yongdong;LIU Xiaoyong;XIANG Chenhui(Department of Urology, ChengdubeixinHospital, Chengdu, Sichuan 610500, China;Department of Urology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, China)

机构地区：[1]成都北新医院泌尿外科,四川成都610500 [2]成都医学院第一附属医院泌尿外科,四川成都610500

出　　处：《现代医药卫生》2018年第10期1469-1470,1475,共3页Journal of Modern Medicine & Health

摘　　要：目的研究腹膜后精索内静脉高位结扎术(HLOISV)治疗精索静脉曲张(VC)的临床疗效。方法选择2015年7月至2016年6月行手术治疗的VC患者88例,按照随机数字表法分为腹膜后组与腹股沟组,每组44例。腹膜后组行经腹膜后HLOISV治疗VC,腹股沟组行经腹股沟HLOISV治疗VC。观察两组术中出血量、手术时间、术后1 d体温、住院时间;观察两组术前1 d及术后12个月A+B级活动力精子、精子密度、精子存活率等精液质量指标;观察术后并发症及术后12个月内复发情况等指标。结果两组术中出血量、手术时间、术后1 d体温、住院时间比较,差异均无统计学意义(P>0.05)。术后12个月,两组A+B级活动力精子、精子密度、精子存活率差异无统计学意义(P>0.05)。腹膜后组术后并发症发病率[6.82%(3/44)]低于腹股沟组[22.73%(10/44)],差异有统计学意义(P<0.05)。腹膜后组复发率为[2.27%(1/44)],与腹股沟组[4.55%(2/44)]比较差异无统计学意义(P>0.05)。结论经腹膜后HLOISV与经腹股沟HLOISV均可有效治疗VC,但经腹膜后HLOISV术后并发症发病率低,更具优势。Objective To investigate the clinical efficacy of varicocele（VC）in the treatment of retroperitoneal variceal vein ligation（HLOISV）.Methods Eighty-eight patients with VC who underwent surgical treatment from July 2015 to June 2016 were randomly divided into retroperitoneal group and inguinal group,44 cases in each group.The retroperitoneal group was treated with retroperitoneal HLOISV for VC and the inguinal group was treated with inguinal HLOISV for VC.The intraoperative blood loss,operation time,body temperature 1 day after surgery and length of stay were observed in two groups.The semen quality indicators such as sperms,sperm density and sperm survival rate in the A＋B class at 1day before surgery and 12months after surgery were observed in two groups.Postoperative complications and recurrence within 12 months after surgery were observed in two groups.Results There was no significant difference in blood loss,operation time,body temperature 1day after surgery and length of stay between the two groups（P〈0.05）.At 12 months after surgery,there was no significant difference in sperm motility,sperm density,and sperm survival rate between the two groups（P〈0.05）.The incidence of postoperative complications in the retroperitoneal group was 6.82%（3/44）,which was lower than 22.73%（10/44）in the inguinal group,the difference was statistically significant（P〈0.05）.The recurrence rate in the retroperitoneal group was 2.27%（1/44）,which was not significantly different from the 4.55%（2/44）in the inguinal group（P〉0.05）.Conclusion Both retroperitoneal HLOISV and transvenous inguinal HLOISV can effectively treat VC,but the incidence of postoperative complications of retroperitoneal HLOISV is lower,which is more advantageous.

关 键 词：腹膜后间隙 结扎术 精索静脉曲张 

分 类 号：R697.24[医药卫生—泌尿科学]