显微镜辅助下精索静脉曲张低位结扎术在精索静脉曲张患者中的应用  

Application of microscope-assisted low varicocelectomy in patients with varicocele

作　　者：玉铂[1] 冉俊武 刘杰[1] YU Bo;RAN Junwu;LIU Jie(Department of Urology,Liuzhou People's Hospital Affiliated to Guangxi Medical University,Guangxi Zhuang Autonomous Region,Liuzhou 545006,China)

机构地区：[1]广西医科大学附属柳州市人民医院泌尿外科,广西柳州545006

出　　处：《中国当代医药》2024年第28期47-51,共5页China Modern Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-B20221366)。

摘　　要：目的探讨显微镜辅助下精索静脉曲张低位结扎术的精液质量改善效果及疗效。方法选取2021年2月至2022年9月广西医科大学附属柳州市人民医院收治的80例精索静脉曲张患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各40例。观察组采用显微镜辅助下精索静脉曲张低位结扎术,对照组进行腹腔镜手术治疗。比较两组术前和术后的精液质量情况(精子浓度、精子总数、精子总活力、形态正常率)、术后疼痛评分以及患者术后1年内伴侣受孕情况。结果观察组术后3个月的精子浓度、精子总活力及形态正常率高于对照组,差异有统计学意义(P<0.05)。观察组患者术后的疼痛情况轻于对照组,差异有统计学意义(P<0.05)。术后1年内,观察组患者伴侣的自然受孕率高于对照组,差异有统计学意义(P<0.05)。结论显微镜辅助下精索静脉曲张低位结扎术对精液质量改善显著,术后疼痛轻,对患者的创伤较小,具有一定的临床推广价值。Objective To investigate the semen quality and therapeutic efficacy of microscope-assisted low varicocelectomy.Methods A total of 80 varicocele patients admitted to Liuzhou People's Hospital Affiliated to Guangxi Medical University from February 2021 to September 2022 were selected as research objects and divided into observation group and control group according to random number table method,with 40 cases in each group.The observation group received microscope-assisted low varicocelectomy,while the control group received laparoscopic surgery.Semen quality(sperm concentration,total sperm count,total sperm motility,normal morphologic rate),postoperative pain score and partner pregnancy within 1 year after surgery were compared between the two groups.Results The sperm concentration,total motility and normal morphologic rate of the observation group were higher than those of the control group 3 months after operation,and the differences were statistically significant(P<0.05).Postoperative pain in the observation group was less severe than that in the control group,and the difference was statistically significant(P<0.05).Within 1 year after surgery,the natural conception rate of partners in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Microscope-assisted low varicocelectomy significantly improves semen quality,with minimal postoperative pain and less trauma to the patients,suggesting its potential clinical value for widespread adoption.

关 键 词：精索静脉曲张 显微镜辅助下精索静脉曲张低位结扎术 精液质量 疗效评估 

分 类 号：R699.8[医药卫生—泌尿科学]