精索静脉曲张患者行高位结扎术后对ASA水平及精子质量影响  

Effect of high ligation operation on ASA level and sperm quality in patients with varicocele

作　　者：于明杰[1] 易虎[1] 金珊[1] 田振涛[1] YU Mingjie;YI Hu;JIN Shan;TIAN Zhentao(Department of Urologic Surgery,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300000,China)

机构地区：[1]天津中医药大学第一附属医院泌尿外科,300000

出　　处：《重庆医学》2020年第9期1446-1449,1454,共5页Chongqing medicine

基　　金：天津市卫生和计划生育委员会中医中西医结合课题(13063)。

摘　　要：目的探讨精索静脉曲张(VC)患者行腹膜后高位结扎术对术后抗精子抗体(ASA)、精子质量等影响。方法选取该院2016年1月至2019年1月手术治疗的VC患者88例,根据手术方式分为腹膜后精索静脉高位结扎术44例(高位结扎组)和经外环口显微镜下精索静脉结扎术44例(显微镜组),比较两组患者手术前及术后3个月的ASA阳性率、精子质量、性激素水平,以及手术时间、住院时间及并发症等。结果术前两组患者精子质量相关指标(精液量、精子浓度、前向运动精子率、精子活动率、精子存活率等)、ASA阳性率、血清睾酮、卵泡刺激素(FSH)及黄体生成素(LH)比较,差异均无统计学意义(P>0.05);术后3个月时,显微镜组患者的精子浓度、前向运动精子率、精子活动率、精子存活率及血清睾酮水平均明显高于高位结扎组,而ASA阳性率及FSH、LH水平均明显低于高位结扎组,差异均有统计学意义(P<0.05)。显微镜组患者手术时间明显长于高位结扎组[(2.02±0.75)h vs.(0.51±0.17)h,P<0.05],但住院时间短于高位结扎组[(2.20±0.61)d vs.(2.96±0.54)d,P<0.05]。显微镜组患者并发症总发生率明显低于高位结扎组,两组比较差异有统计学意义(11.36%vs.34.09%,P<0.05)。结论VC患者行腹膜后精索静脉高位结扎术易于实施,术后ASA抗体阳性率、精子质量等有明显改善,但改善程度不及经外环口显微镜下精索静脉结扎术。Objective To analyze the effect of retroperitoneal high ligation operation on anti-sperm antibody(ASA)and sperm quality in the patients with varicocele(VC).Methods A total of 88 patients with VC treated by operation in this hospital from January 2016 to January 2019 were selected and divided into the retroperitoneal spermatic vein high ligation group(high ligation group,n=44)and group of microscopic spermatic vein ligation through external ring orifice(microscope group,n=44)group.The ASA positive rate,sperm quality,sex hormone levels,operative time,hospitalization time and complications before operation and in postoperative 3 months were compared between the two groups.Results Before operation,there were no statistically significant differences in the sperm quality related indicators(semen volume,sperm concentration,forward motility sperm rate,sperm motility rate,sperm survival rate,etc.),ASA positive rate,serum testosterone,FSH and LH between the two groups(P>0.05).In 3 months after surgery,the sperm concentration,forward motility sperm rate,sperm motility rate,sperm survival rate,and serum testosterone levels in the microscope group were significantly higher than those in the high ligation group,while the ASA positive rate,FSH and LH levels were significantly lower than those in the high ligation group with statistical differece(P<0.05).The operation time in the microscope group was significantly longer than that in the high ligation group[(2.02±0.75)h vs.(0.51±0.17)h,P<0.05],but the hospitalization time was shorter than that in the high ligation group[(2.20±0.61)d vs.(2.96±0.54)d,P<0.05].The total incidence rate of complications in the microscope group was significantly lower than that in the high ligation group,and the differencewas statistically significant(11.36%vs.34.09%,P<0.05).Conclusion Conducting the retroperitoneal spermatic vein high ligation in the patients with VC is easy to implement,postoperative ASA antibody positive rate and sperm quality have obvious improvement,but the improvement degree

关 键 词：精索静脉曲张 抗精子抗体 精子能动性 精索静脉高位结扎术 显微外科手术 

分 类 号：R699.8[医药卫生—泌尿科学]