高压氧联合显微镜下精索静脉结扎术治疗精索静脉曲张伴精液异常的疗效分析  

Clinical efficacy of hyperbaric oxygen combined with microscopic spermatic vein ligation in the treatment of varicocele with semen abnormality

作　　者：朱磊[1] 张魁[1] 杨占锋[1] Zhu Lei;Zhang Kui;Yang Zhanfeng(Department of Urology,First People's Hospital of Shangqiu,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院泌尿外科,商丘476100

出　　处：《中华航海医学与高气压医学杂志》2024年第2期245-248,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：河南省科技攻关项目(LHGJ20200534)。

摘　　要：目的探讨高压氧联合显微镜下精索静脉结扎术治疗精索静脉曲张伴精液异常的疗效。方法选取2019年1月至2021年1月商丘市第一人民医院泌尿外科收治的80例精索静脉曲张伴精液异常患者作为研究对象,根据随机数字表法分为对照组和干预组,每组40例。对照组患者采用显微镜下精索静脉结扎术治疗,干预组患者采用高压氧联合显微镜下精索静脉结扎术治疗,比较2组患者的术中出血量、手术时间、住院时间、术后视觉模拟评分法(VAS)评分;比较2组患者治疗前、治疗后6个月的精子活率、精子密度、活动精子总数、精液液化时间、精液量;比较2组患者术后1、3、6个月的疾病改善率;比较随访1年后2组患者配偶的自然妊娠率。结果2组患者的手术时间、术中出血量、VAS评分、住院时间比较差异无统计学意义(P>0.05);术前2组患者的精子活率、精子密度、活动精子总数比较差异无统计学意义(P>0.05),术后干预组上述指标均优于对照组(P<0.001)。与术前比较,术后6个月2组患者的精液液化时间缩短,精液量增加(P<0.05);术后6个月2组患者的精液液化时间、精液量比较差异无统计学意义(P>0.05)。干预组患者术后1、3、6个月的疾病改善率分别为72.50%、87.50%、95.00%,均高于同期对照组(P<0.05);随访1年后干预组患者的配偶妊娠率为55.00%,高于对照组的32.50%(P<0.05)。结论显微镜下精索静脉结扎术联合高压氧治疗精索静脉曲张伴精液异常患者安全性较高,可改善患者的精液质量,提高其配偶的自然妊娠率。Objective To explore the clinical efficacy of hyperbaric oxygen combined with microscopic spermatic vein ligation in the treatment of varicocele with semen abnormality.Methods A total of 80 patients with varicocele accompanied by semen abnormality admitted to the Department of Urology of the First People's Hospital of Shangqiu from January 2019 to January 2021 were selected as the research subjects and assigned into control group and intervention group according to the random number table method,with 40 cases in each group.The control group was treated with microscopic spermatic vein ligation,and the intervention group was treated with hyperbaric oxygen combined with microscopic spermatic vein ligation.Intraoperative blood loss,operation duration,hospital stay,and scores of postoperative visual analogue scale(VAS)were compared between the two groups.The sperm motility rate,sperm density,total motile sperm,semen liquefaction time,and semen volume of the two groups were compared before treatment and six months after treatment.The disease improvement rates at one month,three months,and six months after surgery were compared between the two groups.Natural pregnancy rates of the spouses of the two groups were compared after one year follow-up.Results There was no statistically significant difference in the comparison of operation duration,intraoperative blood loss,VAS score,and hospital stay between the two groups(P>0.05).There was no statistically significant difference in the comparison of sperm motility,sperm density,and total motile sperm between the two groups before surgery(P>0.05),and the above indexes in the intervention group were better than those in the control group after surgery(P<0.001).Semen liquefaction time was shortened,and semen volume was increased in the two groups six months after surgery(P<0.05),and there was no statistically significant difference in the comparison of semen liquefaction time and semen volume in the two groups six months after surgery(P>0.05).The disease improvement rates at one

关 键 词：高压氧 显微镜下精索静脉结扎术 精液异常 

分 类 号：R699.8[医药卫生—泌尿科学]