显微镜下精索静脉结扎术对精索静脉曲张患者临床疗效及预后的影响  

The clinical effect and prognosis of VC patients with spermatic vein ligation under microscope

作　　者：余兵 郑津荣 陈川聪 林寅生 郑玄同 Yu Bing;Zheng Jinrong;Chen Chuancong;Lin Yinsheng;Zheng Xuantong(The Third Hospital of Zhangzhou,Zhangzhou,Fujian 363000)

机构地区：[1]漳州市第三医院,福建漳州363000

出　　处：《基层医学论坛》2023年第28期10-12,104,共4页The Medical Forum

摘　　要：目的探讨显微镜下精索静脉结扎术对精索静脉曲张(VC)患者睾丸内动脉血流及预后影响。方法回顾性分析漳州市第三医院2018年10月—2021年10月收治的96例精索静脉曲张患者临床资料,将行腹腔镜手术治疗的48例作为对照组,行显微镜下精索静脉结扎术的48例患者作为观察组,术前及术后5个月,对比2组患者睾丸内动脉血流参数及并发症发生率,评估性功能、精子质量。结果治疗前,2组患者睾丸内动脉血流参数对比,差异无统计学意义(P>0.05);治疗后,2组阻力指数(resistance index,RI)、搏动指数(pulsatility index,PI)均较治疗前降低,观察组郐张末期流速(end diastolic velocity,EDV)较治疗前提高,差异有统计学意义P(<0.05),但对照组EDV治疗前后差异无统计学意义(P>0.05);与对照组比较,治疗后观察组RI更低,EDV更高,差异有统计学意义(P<0.05);2组治疗后PI对比,差异无统计学意义(P>0.05);治疗后观察组性功能评分、精子活率及活动精子总数高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率6.25%低于对照组的27.08%,差异有统计学意义P(<0.05)。结论行显微镜下精索静脉结扎术可显著改善患者睾丸内动脉血液流动速度,提高患者性功能及精子质量,且并发症较少,效果显著。Objective To investigate the effect of microscopic spermatic vein ligation on the blood flow and prognosis of the internal testicular artery in patients with varicocele(VC).Methods A retrospective analysis was made of 96 patients with varicocele who were treated in our hospital from October 2018 to October 2021,48 patients who underwent laparoscopic surgery as the control group,and 48 patients who underwent microscopic spermatic vein ligation.As the observation group,the blood flow parameters of the testicular artery were compared between the two groups before and 5 months after the operation,and the sexual function,sperm quality and the incidence of complications were evaluated.Results Before treatment,there was no significant difference in blood flow parameters of testicular artery between the two groups(P>0.05).After treatment,RI and PI in the two groups were lower than those before treatment,and EDV in the observation group was higher than that before treatment(P<0.05),but there was no significant change in EDV in the control group(P>0.05).Compared with the control group,the RI of the observation group was lower and the EDV was higher,the difference was significant(P<0.05).There was no significant difference in PI between the two groups after treatment(P>0.05).The total number of spermatozoa was higher than that in the control group,with a significant difference(P<0.05).The incidence of complications in the observation group was 6.25%lower than that in the control group,which was 27.08%,with a significant difference(P<0.05).Conclusion The spermatic vein ligation under the microscope can significantly improve the blood flow velocity of the internal testicular artery,improve the sexual function and sperm quality of the patient,and the complications are less and the effect is remarkable.

关 键 词：精索静脉曲张 显微镜 结扎术 性功能 睾丸内动脉血流 精子质量 

分 类 号：R699.8[医药卫生—泌尿科学]