不同手术方式治疗精索静脉曲张对睾丸功能的影响  

Effect on testicular function of different surgical procedures for varicocele

作　　者：范晓猛 朱红伟[1] 朱志敏 阴正坤[1] 刘永胜[1] 郝捷[1] 邱爱萍 于红莲[1] 崔铁峰[1] Fan Xiaomeng;Zhu Hongwei;Zhu Zhimin;Yin Zhengkun;Liu Yongsheng;Hao Jie;Qiu Aiping;Yu Honglian;Cui Tiefeng(Department of Urology,Second Hospital of Baoding City,Baoding 071051,China;Department of High Risk Obstetrics,Baoding Maternal and Child Health Hospital,Baoding 071000,China)

机构地区：[1]保定市第二医院泌尿外科,保定071051 [2]保定市妇幼保健院高危产科,保定071000

出　　处：《国际泌尿系统杂志》2022年第3期524-527,共4页International Journal of Urology and Nephrology

基　　金：保定市科技计划项目 (1951ZF012)。

摘　　要：目的比较不同的精索静脉结扎手术方式治疗精索静脉曲张对睾丸功能的影响。方法选择2014年1月至2018年1月在保定市第二医院行左侧精索静脉结扎的57例患者的临床资料,将患者随机分为显微镜组、腹股沟组、腹膜后组,每组各19例。比较三组的手术时间、住院时间和术后1年复查的左睾丸体积、精子密度、精子活动力、血清促卵泡素(FSH)、促黄体生成素(LH)、睾酮(T)、雌二醇(E2)及催乳素(PRL)水平。结果显微镜组的手术时间明显高于腹股沟组和腹膜后组,而住院时间明显低于腹股沟组和腹膜后组,差异均有统计学意义(均P<0.05)。腹股沟组和腹膜后组的手术时间和住院时间比较,差异均无统计学意义(均P>0.05)。术后1年复查,三组的左侧睾丸体积比较,差异无统计学意义(P>0.05);显微镜组的精子密度、精子活动力高于腹股沟组(均P<0.05)。与腹股沟组比较,显微镜组的FSH、LH、E2、PRL下降,T明显上升,差异均有统计学意义(均P<0.05);显微镜组的精子密度高于腹膜后组,差异有统计学意义(P<0.05);显微镜组和腹膜后组的FSH、LH、T、E2、PRL比较,差异均无统计学意义(均P>0.05)。结论通过显微镜手术方式行精索静脉结扎术具有术后恢复快,可有效改善睾丸功能,值得临床推广。Objective To compare the effect on testicular function of different surgical procedures for varicocele.Methods The clinical data of 57 patients who underwent ligation of left spermatic vein in Baoding second hospital from January 2014 to January 2018 were selected and randomly divided into microscope group,inguinal group and retroperitoneal group,with 19 cases in each group.The operation time,hospital stay,left testicular volume,sperm density,sperm motility,serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),estradiol(E2)and prolactin(PRL)were compared among the three groups.Results The operation time of microscope group was significantly higher than that of other two groups,and the length of hospital stay was significantly lower than that of inguinal group and retroperitoneal group,and the difference was statistically significant(allP<0.05).There were no significant differences in operation time and hospital stay between the inguinal group and the retroperitoneal group(all P>0.05).One year after surgery,there was no significant difference in the volume of left testicle among the three groups(P>0.05).The sperm density and motility in microscope group were higher than those in groin group(all P<0.05).Compared with groin group,FSH,LH,E2,PRL decreased and T increased significantly in microscope group,with statistical significance(all P<0.05).The sperm density in the microscope group was higher than that in the retroperitoneal group,and the difference was statistically significant(P<0.05).There were no significant differences in FSH,LH,T,E2 and PRL between the microscope group and the retroperitoneal group(all P>0.05).Conclusions Microscopic varicocele ligation has the characteristics of quick recovery and more obvious improvement of testicular function.

关 键 词：精索静脉曲张 外科手术 睾丸 

分 类 号：R699.8[医药卫生—泌尿科学]