TAPP与TEP对男性腹股沟疝患者睾丸功能及精索血管的影响  

Effects of TAPP and TEP on Testicular Function and Spermatic Vessels in Male Patients with Inguinal Hernia

作　　者：宋志 谈运长 熊欢 汪峰 孙胜 刘来蓬 曹传培 SONG Zhi;TAN Yunchang;XIONG Huan;WANG Feng;SUN Sheng;LIU Laipeng;CAO Chuanpei(Affiliated Hospital of Jiujiang University,Jiujiang 332000,China;不详)

机构地区：[1]九江学院附属医院,江西九江332000

出　　处：《中国医学创新》2022年第26期135-138,共4页Medical Innovation of China

摘　　要：目的:比较腹腔镜下经腹腹膜前疝修补术(TAPP)与腹腔镜下完全腹膜外补片植入术(TEP)对男性腹股沟疝(IH)患者睾丸功能及精索血管的影响。方法:选取九江学院附属医院2019年10月-2021年5月收治的88例男性IH患者,按随机数字表法将其分为对照组与研究组,各44例。对照组行TAPP治疗,研究组行TEP治疗,术后均随访1个月。比较两组睾丸功能(精液量、精子存活率、精子密度、睾酮水平)、精索血管(动脉血流速度、静脉血流速度、动脉管径、静脉管径)及术后并发症发生情况。结果:两组术前、随访1个月精液量、精子存活率、精子密度、睾酮水平比较,差异均无统计学意义(P>0.05)。两组术前、随访1个月动脉血流速度、动脉管径比较,差异均无统计学意义(P>0.05);对照组随访1个月静脉血流速度低于术前,静脉管径高于术前(P<0.05);对照组随访1个月静脉血流速度低于研究组,静脉管径高于研究组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:TAPP与TEP对男性IH患者睾丸功能、精索动脉血管均无显著影响,且手术安全性好,但TEP相比TAPP对患者精索静脉血管影响更小。Objective:To compare the effects of laparoscopic transabdominal preperitoneal prosthesis (TAPP) and laparoscopic total extraperitoneal prosthesis (TEP) on testicular function and spermatic vessels in male patients with inguinal hernia (IH).Method:A total of 88 male IH patients admitted to Affiliated Hospital of Jiujiang University from October 2019 to May 2021 were selected.They were divided into control group and study group according to the random number table method,with 44 cases in each group.The control group was treated with TAPP,while the study group was treated with TEP.All patients were followed up for 1 month.Testicular function (semen volume,sperm survival rate,sperm density,testosterone level),spermatic blood vessels (arterial blood flow velocity,venous blood flow velocity,arterial diameter,venous diameter) and postoperative complications were compared between the two groups.Result:There were no significant differences in semen volume,sperm survival rates,sperm density and testosterone levels between the two groups before surgery,after 1 month of follow-up (P>0.05).There were no significant differences in arterial blood flow velocity and arterial diameter between the two groups before operation and at 1 month of follow-up (P>0.05).At 1 month of follow-up,the venous blood flow velocity in the control group was lower than that before operation,and the venous diameter was higher than that before operation (P<0.05).At 1 month of follow-up,the venous blood flow velocity of the control group was lower than that of the study group,and the venous diameter of the control group was higher than that of the study group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of complications between the two groups (P>0.05).Conclusion:TAPP and TEP have no significant effect on testicular function and spermatic artery in male IH patients,and the operation is safe,but TEP has less effect on spermatic vein than TAPP.

关 键 词：腹股沟疝 腹腔镜 经腹腹膜前疝修补术 完全腹膜外补片植入术 睾丸功能 精索血管 

分 类 号：R656.21[医药卫生—外科学]