腹股沟下显微精索静脉结扎术与腹腔镜途径精索静脉高位结扎术疗效比较  

Comparison of Subinguinal Microscopic and Laparoscopic Ligation of Spermatic Veins for Varicocele

作　　者：罗龙华[1] 冯亮[1] 李冬水[1] 郭良飞 余志勇 肖通 孙翔[1] LUO Long-hua;FENG Liang;LI Dong-shui;GUO Liang-fei;YU Zhi-yong;XIAO Tong;SUN Xiang(Department of Urology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院泌尿外科,南昌330006

出　　处：《实用临床医学（江西）》2022年第2期39-41,106,共4页Practical Clinical Medicine

基　　金：江西省卫生计生委科技计划项目(20175103)。

摘　　要：目的比较腹股沟下显微镜精索静脉结扎术与腹腔镜途径精索静脉结扎术的疗效。方法选择60例接受精索静脉曲张手术治疗的患者作为研究对象,按照随机数字表法将其分为显微组(腹股沟下显微镜精索静脉结扎术)和腹腔镜组(腹腔镜途径精索静脉高位结扎术),每组30例。比较2组的治疗效果及并发症发生情况。结果2组均顺利完成手术,显微镜组较腹腔镜组手术时长更长,住院时间更短(t=40.38、17.66,P<0.05)。显微镜组术后6个月精子密度、精子前向运动百分比高于腹腔镜组(t=5.65、6.23,P<0.05)。腹腔镜组阴囊水肿/血肿、阴囊不适发生率高于显微镜组(χ^(2)=7.69、7.74,P<0.05),2组均未见切口感染、睾丸鞘膜积液及睾丸萎缩发生。2组术后6个月复发率比较差异无统计学意义(χ^(2)=4.29,P>0.05)。结论腹股沟下显微精索静脉结扎术较腹腔镜途径精索静脉高位结扎术,精索静脉曲张患者的精子质量更优,且术后并发症发生率更低。Objective To compare the effects of microscopic and laparoscopic ligation of spermatic veins on varicocele.Methods Sixty patients with varicocele were randomly assigned to receive either subinguinal microscopic spermatic vein ligation(microscopic treatment group)or laparoscopic spermatic vein ligation(laparoscopic treatment group),with 30 patients in each group.Therapeutic effect and complications were compared between the two groups.Results The operation was successfully completed in both groups.The microscopic treatment group had a longer operation time and a shorter hospital stay than the laparoscopic treatment group(t=40.38 and 17.66,respectively;P<0.05).Furthermore,the density of sperm and the percentage of sperm with forward movement in the microscopic treatment group were higher than those in the laparoscopic treatment group 6 months after operation(t=5.65 and 6.23,respectively;P<0.05).The incidences of scrotal edema/hematoma and scrotal discomfort in the laparoscopic treatment group were higher than those in the microscopic treatment group(χ^(2)=7.69 and 7.74,respectively;P<0.05).No incision infection,tunica vaginalis hydrocele and testicular atrophy were observed in both groups.There was no significant difference in recurrence rate between the two groups 6 months after operation(χ^(2)=4.29,P>0.05).Conclusion Compared with laparoscopic spermatic vein ligation,subinguinal microscopic spermatic vein ligation can improve sperm quality and reduce postoperative complications in patients with varicocele.

关 键 词：精索静脉曲张 显微外科 腹腔镜 精索静脉结扎术 

分 类 号：R691.1[医药卫生—泌尿科学]