原发性精索静脉曲张患者在显微镜下腹股沟外环下切口精索脉管系统的术中解剖结构特点  

Intraoperative anatomical structure characteristics of the spermatic cord vasculature of patients with primary varicocele undergoing a subinguinal external ring incision under a microscope

作　　者：李剑军[1] 周建华[1] 陈统权 徐潮樟 张炎 Li Jianjun;Zhou Jianhua;Chen Tongquan;Xu Chaozhang;Zhang Yan(Department of Urology,the People's Hospital of Longgang District,Shenzhen,Guangdong Shenzhen 518000)

机构地区：[1]深圳市龙岗区人民医院泌尿外科,广东深圳518000

出　　处：《中国社区医师》2021年第23期36-37,共2页Chinese Community Doctors

摘　　要：目的:观察显微镜下原发性精索静脉曲张患者腹股沟外环下切口术中精索脉管系统的解剖结构特点。方法:2018年1月-2020年3月收治原发性精索静脉曲张患者60例,均进行显微镜下腹股沟外环下切口精索静脉结扎术,术中观察精索内解剖各层的淋巴管、静脉、动脉数目。结果:显微镜下显示,精索淋巴管与精索动静脉随行,管壁较薄弱,管径较细,管道无色;精索动脉表现为具有搏动性,管壁具有韧性,管道呈深红色;精索静脉显示相互之间呈网状吻合,静脉分支扩张、迂曲、数量较多,管径较粗大,饱满充盈,管道呈深蓝色;精索内静脉层左右两侧的脉管数目、提睾肌层左右两侧的脉管数目、输精管层左右两侧的脉管数目比较,差异均无统计学意义(P>0.05)。结论:显微镜下可清晰识别腹股沟外环下切口精索脉管系统各层的淋巴管、动静脉结构特征,避免术中误扎、漏扎淋巴管、动脉、静脉。Objective:To observe the characteristics of the intraoperative anatomical structure of the spermatic cord vasculature in patients with primary varicocele under a microscope.Methods:From January 2018 to March 2020,60 patients with primary varicocele were selected,all of them underwent microscopic ligation of the spermatic vein through the incision under the outer ring of the groin.The number of lymphatic vessels,veins and arteries in each layer of spermatic cord was observed during the operation.Results:Under the microscope,the spermatic lymphatic vessels were accompanied by the spermatic arteries and veins,the walls were weak,the diameter of the tubes were thin,and the tubes were colorless;The spermatic arteries appeared to be pulsating,the walls of the tubes were tough,and the tubes were dark red.The spermatic veins show a net-like anastomosis with each other,the branches of the veins are expanded,tortuous,and the number is large,the diameter of the veins is large and full,the pipeline is dark blue.There was no statistically significant difference in the number of vessels on the left and right sides of the internal spermatic vein layer,the number of vessels on the left and right sides of the cremaster muscle layer,and the number of vessels on the left and right sides of the vas deferens layer(P>0.05).Conclusion:Under the microscope,the structural features of lymphatic vessels,arteries and veins in each layer of spermatic cord vasculature can be clearly identified under the incision under the outer ring of the groin,so as to avoid mistakenly ligating or missing lymphatic vessels,arteries and veins during the operation.

关 键 词：原发性精索静脉曲张 解剖结构 显微外科手术 精索脉管系统 

分 类 号：R699.8[医药卫生—泌尿科学]