显微镜下精索内静脉高位结扎术对精索静脉曲张患者雄性激素、免疫功能及精液质量的影响  

Effects of High Ligation of Internal Spermatic Vein Under Microscope on Androgen,Immune Function and Semen Quality in Patients with Varicocele

作　　者：李小滨[1] 邓克非[1] 杨健 LI Xiao-bin;DENG Ke-fei;YANG Jian(Department of Urology Surgery,the First People's Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院泌尿外科,四川自贡643000

出　　处：《解放军医药杂志》2022年第3期54-57,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省科技计划项目(18ZB0156)。

摘　　要：目的探究显微镜下精索内静脉高位结扎术对精索静脉曲张(VC)患者雄性激素、免疫功能及精液质量的影响。方法选取本院2018年3月—2021年3月诊治的92例VC,按照术式的不同分为A组47例和B组45例。A组采用显微镜下精索内静脉高位结扎术治疗,B组采用传统开放高位结扎术治疗。观察2组住院时间与手术时间,手术前后雄性激素[促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)],免疫功能[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]及精液质量(总精子数、精子浓度、精子活率)水平。结果A组手术时间、住院时间均短于B组(P<0.01)。术后3个月,2组血清LH、FSH水平低于术前,血清T水平高于术前,且A组血清LH、FSH水平低于B组,血清T水平高于B组(P<0.05,P<0.01)。术后1周,2组血清IgA、IgM、IgG水平均升高,且A组高于B组(P<0.05,P<0.01)。术后3个月,2组总精子数、精子浓度及精子活率均升高,且A组高于B组(P<0.05,P<0.01)。结论显微镜下精索内静脉高位结扎术可以明显改善VC患者雄性激素水平,提高免疫功能及精液质量。Objective To investigate effects of high ligation of internal spermatic vein under microscope on androgen,immune function and semen quality in patients with varicocele(VC).Methods A total of 92 patients with VC diagnosed and treated between March 2018 and March 2021 were divided into group A(n=47)and group B(n=45)according to different surgical schemes.Group A was treated with high ligation of internal spermatic vein under microscope,awhile group B was treated with traditional open high ligation.Length of stay,operative duration,levels of androgens[luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)],immune function[immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG)]and semen quality(total sperm count,sperm concentration,sperm viability)before and after operation were observed in two groups.Results Operative duration and length of stay in group A were significantly shorter than those in group B(P<0.01).After operation for 3 months,serum levels of LH and FSH were significantly lower,while serum levels of T were significantly higher than those before treatment in two groups;compared with those in group B,serum levels of LH and FSH were significantly lower,while serum T level was significantly higher in group A(P<0.05,P<0.01).After operation for 1 week,serum levels of IgA,IgM and IgG were significantly higher than those before operation in two groups,and the levels in group A were significantly higher than those in group B(P<0.05,P<0.01).After operation for 3 months,values of the total sperm count,sperm concentration and sperm viability were significantly higher than those before operation in two groups,and the values in group A were significantly higher than those in group B(P<0.05,P<0.01).Conclusion High ligation of internal spermatic vein under microscope may significantly improve androgen level,immune function and semen quality in patients with VC.

关 键 词：精索静脉曲张 显微外科手术 精索静脉高位结扎术 促黄体生成素 免疫球蛋白 精液分析 

分 类 号：R699.8[医药卫生—泌尿科学]