门诊日间手术显微镜下精索静脉结扎治疗精索静脉曲张的临床疗效  

Clinical efficacy of microscopic spermatic vein ligation in outpatient day surgery for varicocele

作　　者：薛芃[1] 汪岩[2] 严璞[1] 周永建[1] 宗焕涛[1] 王晓雁[1] 张勇[1] Xue Peng;Wang Yan;Yan Pu;Zhou Yongjian;Zong Huantao;Wang Xiaoyan;Zhang Yong(Department of Urology,Neurology Sub-center China National Clinical Research Center for Neurological Diseases,Beijing Tiantan Hospital,Capital Medical University,Beijing 100071,China;Department of Vascular Surgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100071,China)

机构地区：[1]首都医科大学附属北京天坛医院泌尿外科,国家神经系统疾病临床医学研究中心神经泌尿研究分中心,北京100071 [2]首都医科大学附属北京天坛医院血管外科,北京100071

出　　处：《血管与腔内血管外科杂志》2022年第12期1432-1435,1471,共5页Journal of Vascular and Endovascular Surgery

基　　金：北京市自然科学基金(7192058);北京市医管局“扬帆计划”重点医学专业发展计划(ZYLX201820);北京市医管中心“登峰”计划(DFL20190502)。

摘　　要：目的 探讨门诊日间手术显微镜下精索静脉结扎治疗精索静脉曲张的治疗效果和安全性。方法 收集2018年1月至2022年5月首都医科大学附属北京天坛医院收治的177例精索静脉曲张患者的临床资料,将2018年1月至2019年12月于住院部行显微镜下精索静脉结扎治疗的85例精索静脉曲张患者作为住院组,将2020年1月至2022年5月于门诊行日间手术显微镜下精索静脉结扎治疗的92例精索静脉曲张患者作为日间组。比较两组患者手术时间、手术前后的精液检测指标、症状改善情况以及术后并发症发生情况。结果 日间组患者在院时间短于住院组患者,差异有统计学意义(P<0.05)。两组患者手术时间比较,差异无统计学意义(P>0.05)。术后1周,两组患者睾丸疼痛显著缓解率、阴囊水肿率比较,差异均无统计学意义(P>0.05)。术后1周,两组患者精子浓度、精子总活力均高于本组术前,差异均有统计学意义(P<0.05);但两组患者精子浓度、精子总活力比较,差异均无统计学意义(P>0.05)。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 门诊日间手术显微镜下精索静脉结扎治疗精索静脉曲张与住院手术治疗具有相似的疗效和安全性,同时缩短了患者的在院时间,节约了医疗资源,值得在临床上推广应用。Objective To investigate the therapeutic effect and safety of microscopic spermatic vein ligation in outpatient day surgery for varicocele. Method The clinical data of 177 patients with varicocele admitted to Beijing Tiantan Hospital, Capital Medical University from January 2018 to May 2022 were collected. Eighty-five patients with varicocele who underwent microscopic spermatic vein ligation in the inpatient department from January 2018to December 2019 were selected as the inpatient group. Ninety-two patients with varicocele who underwent daytime surgical microscopical varicocele ligation in the outpatient department from January 2020 to May 2022 were selected as the daytime group. The operation time, semen detection indexes before and after the operation, symptom improvement,and postoperative complications were compared between the two groups. Result The hospitalization time of patients in the day group was significantly shorter than that of the inpatient group, the difference was statistically significant(P<0.05). There was no significant difference in the operation time between the two groups(P>0.05). One week after the operation, there were no significant differences in the significant relief rate of testicular pain and the rate of scrotal edema between the two groups(P>0.05). One week after the operation, the sperm concentration and total sperm motility of the two groups were significantly higher than those before the operation, the differences were statistically significant(P<0.05). However, there were no significant differences in sperm concentration and total sperm motility between the two groups(P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Microscopic spermatic vein ligation in outpatient day surgery for varicocele has similar efficacy and safety to inpatient surgery. At the same time, this method shortens the time of patients in the hospital and saves medical resources, which is worthy of clinical application.

关 键 词：精索静脉曲张 显微镜下精索静脉结扎 日间手术 疗效 安全性 

分 类 号：R543[医药卫生—心血管疾病]