显微镜精索静脉结扎术治疗精索静脉曲张的疗效及对精子质量、复发率的影响  

Efficacy of microsurgical varicocelectomy in the treatment of varicocele and its influence on sperm quality and recurrence rate

作　　者：王华康 黄华松[1] 周明 郑重 冯洁 WANG Huakang;HUANG Huasong;ZHOU Ming;ZHENG Zhong;FENG Jie(Department of Urology,Xichang People's Hospital,Xichang 615000,China)

机构地区：[1]四川省西昌市人民医院泌尿外科,615000

出　　处：《中国煤炭工业医学杂志》2023年第6期621-625,共5页Chinese Journal of Coal Industry Medicine

基　　金：四川省卫生健康科研课题(编号:20PJ02186)。

摘　　要：目的探讨显微镜精索静脉结扎术治疗精索静脉曲张(varicocele,VC)的疗效及对精子质量、复发率的影响。方法将该院2020年12月—2021年12月收治的112例VC患者以随机数字表法分为对照组及观察组各56例,对照组予传统开放高位结扎术,观察组予显微镜精索静脉结扎术,记录二组围术期指标,并观察二组术前及术后6个月多普勒超声参数及精子质量变化,随访6个月,统计二组并发症发生率及精索静脉曲张复发率。结果二组术中出血量及住院时间比较,差异无统计学意义(P>0.05);观察组手术时间长于对照组,但术后3d疼痛视觉模拟评分(visual analogue scale,VAS)低于对照组(P<0.05)。观察组术后6个月精索静脉反流时间及精索静脉最大反流速度短于对照组(P<0.05),二组精索静脉直径对比,差异无统计学意义(P>0.05)。观察组术后6个月总精子数、精子浓度、A+B级活动力精子占比及精子活率均高于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05),二组术后复发率对比,差异无统计学意义(P>0.05)。结论显微镜精索静脉结扎术治疗VC疗效显著,可减轻患者术后疼痛感,改善精索静脉血流状态,提高精子质量,还能降低术后并发症发生率及复发率,手术效果较为理想。Objective To explore the efficacy of microsurgical varicocelectomy in the treatment of varicocele(VC)and its influence on sperm quality and recurrence rate.Methods:Totally one hundred and twelve patients with VC who were treated in the hospital from December 2020 to December 2021 were divided into control group and observation group by the random number table method,with 56 cases in each group.The control group was treated with traditional open high ligation while the observation group was given microsurgical varicocelectomy.The perioperative indicators in the two groups were recorded,and the Doppler ultrasound parameters and sperm quality changes were observed in the two groups before surgery and at 6 months after surgery.After 6 months of follow-up,the incidence rates of complications and recurrence rate of varicocele in the two groups were statistically analyzed.Results There were no statistical differences in intraoperative blood loss and hospital stay between the two groups(P>0.05).The surgical time in observation group was longer than that in control group,but the Visual Analogue Scale(VAS)score at 3 days after surgery was lower compared with that in control group(P<0.05).The spermatic vein reflux time and the maximum spermatic vein reflux velocity were shorter or slower in observation group than those in control group at 6 months after surgery(P<0.05),but there was no statistical significance in spermatic vein diameter between the two groups(P>0.05).The total sperm count,sperm concentration,proportion of grade A+B motile sperm and sperm motility rate in observation group were higher compared to control group at 6 months after surgery(P<0.05).The incidence rates of postoperative complications in observation group were lower than those in control group(P<0.05),but there was no statistically significant difference in the postoperative recurrence rate between the two groups(P>0.05).Conclusion Microscopic varicocelectomy has a significant efficacy in the treatment of VC,and it can relieve the postoperative pain

关 键 词：显微镜精索静脉结扎术 精索静脉曲张 疗效 精子质量 复发率 

分 类 号：R697.2[医药卫生—泌尿科学]