腹腔镜下精索静脉高选择性结扎手术疗效探究与分析  

Exploration and Analysis of Curative Effect of Laparoscopic High-selective Ligation of Spermatic Vein

作　　者：黄小龙 张思州[1] 潘俊呈 顾洪 徐世田[1] 温鹏[1] HUANG Xiaolong;ZHANG Sizhou;PAN Juncheng;GU Hong;XU Shitian;WEN Peng(People’s Hospital of Hechuan District in Chongqing City,Chongqing 401520,China;不详)

机构地区：[1]重庆市合川区人民医院,重庆401520

出　　处：《中国医学创新》2020年第24期120-123,共4页Medical Innovation of China

摘　　要：目的:通过对治疗精索静脉曲张(VC)的两种不同的腹腔镜术式进行比较分析,以探究腹腔镜下精索静脉高选择性结扎术治疗VC的临床效果。方法:回顾性分析2017年6月-2019年4月本院收治的87左侧VC行腹腔镜手术治疗患者的临床资料。根据术式的不同分为观察组42例和对照组45例。观察组采取腹腔镜下精索静脉高选择性结扎术,对照组采取腹腔镜下精索静脉集束结扎术。比较两组手术时间、术中出血量、术中皮下气肿及住院时间,术后随访6个月,比较两组症状缓解、复发、精液改善情况以及术后并发症发生情况。结果:对照组手术时间短于观察组,术中出血量少于观察组,差异均有统计学意义(P<0.05)。观察组鞘膜积液、睾丸萎缩发生率均低于对照组,差异均有统计学意义(P<0.05)。两组症状缓解率、VC复发率比较,差异均无统计学意义(P>0.05)。两组术后精子数量和精子活力(a级+b级)均较术前明显改善,差异均有统计学意义(P<0.05)。结论:两种腹腔镜手术方式治疗精索静脉曲张均可获得较好的临床效果,而腹腔镜下精索静脉高选择性结扎术后鞘膜积液、睾丸萎缩发生率更低。Objective:To explore the clinical efficacy of laparoscopic high-selective ligation of spermatic vein in the treatment of VC through the comparative analysis of two different laparoscopic methods for the treatment of varicocele(VC).Method:The clinical data of 87 patients with left VC treated by laparoscopic surgery in our hospital from June 2017 to April 2019 were retrospectively analyzed.According to different operation methods,they were divided into the observation group(n=42)and the control group(n=45).The observation group underwent laparoscopic high-selective ligation of the spermatic vein,the control group underwent laparoscopic cluster ligation of spermatic vein.The operative time,blood loss,intraoperative subcutaneous emphysema and length of hospital stay of two groups were compared.The patients were followed up for 6 months after operation,and the symptoms,recurrence,semen improvement and postoperative complications of two groups were compared.Result:The operative time of the control group was shorter than that of the observation group,the intraoperative blood loss was less than that of the observation group,there were statistically significant differences(P<0.05).The incidence of sheath effusion and testicular atrophy in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences between two groups in symptom remission rate and VC recurrence rate(P>0.05).The sperm count and sperm motility(grade A+grade B)in two groups after operation were significantly improved compared with those of before operation,the differences were statistically significant(P<0.05).Conclusion:Two laparoscopic methods for treating varicocele can achieve good clinical efficacy,while the incidence of sheath effusion and testicular atrophy after laparoscopic highselective ligation of spermatic vein is lower.

关 键 词：腹腔镜 精索静脉高选择性结扎术 精索静脉集束结扎术 精索静脉曲张 

分 类 号：R699.8[医药卫生—泌尿科学]