改良阴囊镜手术在治疗睾丸鞘膜积液中的应用  

Modified scrotoscopic surgery for testicular hydrocele

作　　者：冯天昊 姚爱兵 蒋齐 朱晓峰 熊宇 宋震乾 陆烽烽 江斌[1] 位志峰 FENG Tian-hao;YAO Ai-bing;JIANG Qi;ZHU Xiao-feng;XIONG Yu;SONG Zhen-qian;LU Feng-feng;JIANG Bin;WEI Zhi-feng(Department of Urology,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 211800,China)

机构地区：[1]南京医科大学第四附属医院泌尿外科,江苏南京211800

出　　处：《中华男科学杂志》2024年第10期910-914,共5页National Journal of Andrology

摘　　要：目的:探讨改良阴囊镜手术在治疗睾丸鞘膜积液的应用。方法:选取睾丸鞘膜积液患者45例,分为常规阴囊镜(TSS)组22例和改良阴囊镜(MSS)组23例。MSS主要改良点在于术中使用向内弯折60°的针状电极替代TSS手术中的环状电极。记录并分析比较两组患者的一般资料、手术时间、切口长度、术中损伤、切口感染、阴囊水肿、术后住院时间、术后阴囊疼痛视觉模拟评分(VAS)。结果:TSS组与MSS组在患者一般资料中无显著差异(P>0.05)。与TSS组相比,MSS组在手术时间[TSS:(32.86±3.80)min,MSS:(26.13±2.81)min,P<0.05]、切口长度[TSS:(14.09±2.23)mm,MSS:(8.73±1.48)mm,P<0.05]、术后住院时间[TSS:(4.36±1.05)d,MSS:(2.00±0.90)d,P<0.05]均有明显优势;术后第1、2、3、7天切口VAS评分,MSS组显著低于TSS组[术后第1天:(3.09±0.79)分vs(4.41±1.05)分;术后第2天:(2.78±1.13)分vs(3.36±1.05)分;术后第3天:(1.74±0.86)分vs(2.65±0.72)分;术后第7天:(1.04±0.82)分vs(1.91±0.81)分,P均<0.05];术后第3、7天MSS组阴囊水肿明显轻于TSS组(P均<0.05)。两组均未导致睾丸或附睾损伤,均未出现伤口感染。结论:改良阴囊镜手术在治疗睾丸鞘膜积液中的应用安全有效,具有缩短手术时间、减小手术切口、减轻术后疼痛及阴囊水肿等优点。Objective:To explore the application of modified scrotoscopic surgery(MSS) in the treatment of testicular hydrocele.Methods:We selected 45 cases of testicular hydrocele for this study,22 treated by traditional scrotoscopic surgery(TSS) and the other 23 by MSS,which was performed with a pin-shaped electrode bent inward at an angle of 60° instead of a circular electrode used in TSS.We recorded the general clinical data,operation time,incision length,intraoperative injury,incision infection,scrotal edema,postoperative hospital stay and postoperative Visual Analogue Scale(VAS) scores of the patients and compared them between the two groups.Results:There was no statistically significant difference in the general clinical data between the two groups(P > 0.05).Compared with the patients of the TSS group,those of the MSS group showed significantly shorter operative time([32.86 ± 3.80] vs [26.13 ± 2.81] min,P<0.05),incision length([14.09 ± 2.23] vs [8.73 ± 1.48] mm,P<0.05) and postoperative hospital stay([4.36 ± 1.05] vs [2.00 ± 0.90] d,P<0.05),and achieved remarkably lower VAS scores on postoperative days 1(4.41 ± 1.05 vs 3.09 ± 0.79,P<0.05),2(3.36 ± 1.05 vs 2.78 ± 1.13,P<0.05),3(2.65 ± 0.72 vs 1.74 ± 0.86,P<0.05) and 7(1.91 ± 0.81 vs 1.04 ± 0.82,P<0.05).At 3 and 7 days after surgery,scrotal edema was markedly milder in the MSS than in the TSS group(P<0.05).No testicular or epididymal damage,or wound infection occurred in either of the two groups.Conclusion:MSS is safe and effective in the treatment of testicular hydrocele,superior to TSS for its advantages of shorter operation time,smaller surgical incision,less postoperative pain and milder scrotal edema.

关 键 词：改良阴囊镜手术 睾丸鞘膜积液 疗效评价 

分 类 号：R699.8[医药卫生—泌尿科学]