腹腔镜下高位结扎手术治疗精索静脉曲张的临床疗效  

Clinical efficacy of laparoscopic high ligation in the treatment of varicocele

作　　者：郑慧杰 谭公祥 陈亚梅 余明主[1] ZHENG Huijie;TAN Gongxiang;CHEN Yamei;YU Mingzhu(Department of Urology,The 908th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Nanchang,Jiangxi,330002,China)

机构地区：[1]中国人民解放军联勤保障部队第908医院泌尿外科,江西南昌330002

出　　处：《当代医学》2024年第34期42-46,共5页Contemporary Medicine

摘　　要：目的探讨腹腔镜下高位结扎手术治疗精索静脉曲张(varicocele,VC)的临床疗效。方法选取2019年1月至2021年12月中国人民解放军联勤保障部队第908医院收治80例VC患者作为研究对象,采用随机数字表法分为对照组与观察组,每组40例。对照组行开放性VC结扎术,观察组行腹腔镜下高位结扎手术。比较两组临床疗效、精液质量、激素指标[卵泡刺激素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)]、睾丸体积、精索静脉最大直径、手术相关指标、术后并发症发生率。结果观察组治疗总有效率为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05)。术后,观察组精力活力(a+b)级比例、精子存活率均高于对照组,精子密度大于对照组,差异有统计学意义(P<0.05)。术后,观察组血清FSH、LH水平均低于对照组,T水平高于对照组,差异有统计学意义(P<0.05)。术后,观察组睾丸体积大于对照组,精索静脉最大直径短于对照组,差异有统计学意义(P<0.05)。观察组术中出血量少于对照组,住院时间、手术时间、肠道功能恢复时间均短于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为2.50%,低于对照组的17.50%,差异有统计学意义(P<0.05)。结论腹腔镜下高位结扎手术治疗VC的疗效显著,且创伤小,能提升精液质量,增大睾丸体积,缩短精索静脉最大直径,加快康复进程,改善激素水平,且并发症少,值得临床推广应用。Objective To investigate the clinical efficacy of laparoscopic high ligation in the treatment of varicocele(VC).Methods A total of 80 VC patients admitted to The 908th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from January 2019 to December 2021 were selected as the study subjects,and they were divided into the control group and the observation group by random number table method,with 40 cases in each group.The control group underwent open VC ligation,and the observation group underwent laparoscopic high ligation.The clinical efficacy,semen quality,hormone indexes(follicle stimulating hormone[FSH],luteinizing hormone[LH],testosterone[T]),testicular volume,maximum diameter of spermatic vein,surgery-related indicators,postoperative complications were compared between the two groups.Results The total effective rate in the observation group was 95.00%,which was higher than 77.50%in the control group,the difference was statistically significant(P<0.05).After operation,the ratio of the energy and vitality(a+b)grade,spermatozoa survival rate in the observation group were higher than those in the control group,and spermatozoa density was larger than that in the control group,and the differences were statistically significant(P<0.05).After operation,the serum FSH and LH levels in the observation group were lower than those in the control group,and the serum T levels were higher than those in the control group,the differences were statistically significant(P<0.05).After operation,the testicular volume in the observation group was larger than that in the control group,and the maximum diameter of the spermatic vein was shorter than that in the control group,the differences were statistically significant(P<0.05).The intraoperative blood loss in the observation group was less than that in the control group,and the length of hospital stay,operation time and intestinal function recovery time were shorter than those in the control group,the differences were statistically significant(P<0.05

关 键 词：腹腔镜下高位结扎手术 精索静脉曲张 精液质量 激素 

分 类 号：R47[医药卫生—护理学]