无超声引导的腹股沟下显微精索静脉结扎术的安全性分析  

The Safety of Microsurgical Subinguinal Varicocelectomy Without the Ultrasound Guiding

作　　者：高金龙[1] 傅强[1] 胡钊[1] 苏伟鹏 赖载礼[1] GAO Jin-long;FU Qiang;HU Zhao;SU Wei-peng;LAI Zai-li(Department of Urology,TCM Hospital of Xiamen City,Fujian Xiamen 361000)

机构地区：[1]厦门市中医院泌尿外科,福建厦门361000

出　　处：《中国医疗器械信息》2024年第22期104-106,共3页China Medical Device Information

摘　　要：目的:观察无超声引导的腹股沟下显微精索静脉结扎术(MSV)的安全性及手术疗效。方法:2013年1月~2022年12月,101例左侧精索静脉曲张的患者接受了无超声引导的MSV术,术后随访2~12个月。结果:住院时间2d或3d。平均手术时间(95.0±13.5)min,术中找到1条睾丸动脉的患者占35.6%,2条占53.5%,3条占10.9%。随访期间:复发率为1%,未发生睾丸鞘膜积液、睾丸萎缩等并发症;阴囊痛缓解率为100%(7例);不育症患者(共74例,其中66例得到有效随访),精液密度改善率为68.2%,向前(运动)精子改善率为65.2%,总体改善率为84.8%,精液恢复正常率为22.7%;找到1条睾丸动脉与找到多条的患者,精液质量改善情况比较,差异无统计学意义(P>0.05)。结论:本研究初步显示无超声引导的MSV术应是安全、可行的。Objective:To observe the safety and outcomes of microsurgical subinguinal varicocelectomy without the guide of ultrasound.Methods:From January 2013 to December 2022,101 patients with left side varicocele who underwent microsurgical subinguinal varicocelectomy without the guide of ultrasound.The followup range:2 to 12 months.Results:The hospital stay was 2 or 3 days,average operative time was(95.0±13.5)min.During the operation,we found 1 testicular artery in 35.6%of the patients,2 testicular arteries in 53.5%and 3 testicular arteries in 10.9%.At follow-up,postoperative recurrency rate was 1%,none of the patients had developed hydrocele,testicular atrophy,or other postoperative complications.The rate of testicular pain relieved was 100%(7 cases).In the infertility cases(total 74 cases,and 66 cases get effective semen specimens in the follow-up),semen concentration improvement rate was 68.2%,forward sperm improvement rate was 65.2%,and semen total improvement rate was 84.8%,semen return to normal was 22.7%.The difference of semen improvement was not statistically significant(P>0.05)between the patients who were found 1 testicular artery and more.Conclusion:Our study preliminarily indicate microsurgical subinguinal varicocelectomy without the guide of ultrasound is safe and feasible.

关 键 词：精索静脉曲张 显微精索静脉结扎术 不育症 精液质量 

分 类 号：R699.8[医药卫生—泌尿科学]