双侧精索静脉曲张在门诊局麻下行左侧显微结扎的疗效评价  

Efficacy evaluation of performing left:-side microsurgical varicocelectomy under outpatient local anesthesia with bilateral varicocele

作　　者：潘通[1] 廖黎黎[1] 黄大雄 李杨 黄永汉[1] PAN Tong;LIAO Lili;HUANG Daxiong;LI yang;HUANG Yonghan(Reproductive Medicine Center,the First People's Hospital of Foshan,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市第一人民医院生殖医学中心,广东佛山528000

出　　处：《中国性科学》2024年第7期9-12,共4页Chinese Journal of Human Sexuality

基　　金：佛山市“十四五”医学高水平重点专科建设项目(FSGSP145020)。

摘　　要：目的分析双侧精索静脉曲张(VC)患者门诊局麻下单独做左侧精索静脉曲张显微结扎术(MV)的治疗效果。方法回顾性分析2020年3月至2022年10月在佛山市第一人民医院生殖医学中心行MV治疗的42例双侧VC患者的临床资料。所有患者均在门诊局麻条件下实施左侧MV。比较患者手术前后B超下VC病情发展情况,比较手术前后精子质量参数变化。结果患者于手术后1个月复查阴囊B超示:右侧VC消失率为52.4%(22/42)。于手术后3个月复查,精子浓度、精子总数、前向运动精子百分率、精子存活率均显著高于术前,精子DNA碎片率显著低于术前,差异均具有统计学意义(P<0.05)。结论双侧VC患者在门诊局麻下可优先采取单纯行左侧MV手术的策略,如术后复查阴囊B超发现右侧VC消失,可以不需再次手术,以避免过度治疗。Objective To analyze the efficacy of performing left-side microsurgical varicocelectomy(MV)under outpatient local anesthesia with bilateral varicocele(VC).Methods Clinical data of 42 male patients with bilateral VC who received MV in the Reproductive Medicine Center of the First People′s hospital of Foshan from March 2020 to October 2022 were analyzed.All outpatients were performed left-side MV under outpatient local anesthesia.The development of VC under doppler ultrasound and the sperm quality parameters before and after surgery were compared.Results The patients′scrotal Doppler ultrasound were reexamined 1 month after surgery and showed the disappearance rate of VC on the right side was 52.4%(22/42).Reexamination 3 months after surgery showed the sperm concentration,total sperm count,sperm progressive mobility and survival rate were significantly improved than before surgery,and the sperm DNA fragmentation index was significantly decreased than before surgery,with statistically significant differences(P<0.05).Conclusions For patients with bilateral VC,strategy of left-side MV under outpatient local anesthesia can be preferred.The resurgery may not be necessary to avoid overtreatment if the right-side VC disappeared reexamined by scrotal doppler ultrasound.

关 键 词：精索静脉曲张 精子 双侧 显微外科 局麻 门诊 

分 类 号：R691[医药卫生—泌尿科学]