显微镜下精索静脉结扎术对精索静脉曲张患者的治疗效果

发布时间：2018-06-01 18:26

本文选题：显微镜 + 精索静脉结扎术　；参考：《中华男科学杂志》2017年12期

【摘要】：目的:探讨显微镜下精索静脉结扎术对精索静脉曲张患者的治疗效果。方法:选择2011年9月至2015年2月来我院进行治疗的精索静脉曲张患者120例,随机分为试验组和对照组,各60例。试验组行显微镜下精索静脉结扎术,对照组患者行传统开放高位结扎术。对比手术前后两组患者平静呼吸和作Valsalva动作后精索静脉内径、精索静脉返流时间、睾丸包膜动脉血流数值和精液质量。结果:组间比较显示,术后3个月试验组患者精索静脉返流时间显著短于对照组患者[(0.41±0.1)s vs(1.08±0.1)s,P0.05],术后3个月试验组患者精索静脉最大内径在静息、Valsalva动作状态下均超过对照组[(1.63±0.07)mm vs(1.59±0.06)mm,(1.72±0.05)mm vs(1.68±0.07)mm,P均0.05];术后3个月试验组患者睾丸包膜动脉收缩期最大流速(PSV)(9.26±1.35 vs 10.64±1.28,P0.05)、血管阻力指数(RI)(0.52±0.03 vs 0.61±0.03,P0.05)均较对照组明显减少;术后3个月试验组患者精子浓度[(46.84±5.24)×106/ml vs(35.35±4.26)×106/ml,P0.05]、精子活率[(63.75±7.73)%vs(53.87±6.46)%,P0.05]及总精子计数[(89.54±7.95)×106/ml vs(75.24±8.43)×106/ml,P0.05)]均高于对照组。结论:本研究结果显示,显微镜下精索静脉结扎术疗效确切,可以有效改善睾丸血流,提高精液质量,值得临床推广。
[Abstract]:Objective: to investigate the effect of microscopically ligated spermatic vein on patients with varicocele. Methods: 120 patients with varicocele treated in our hospital from September 2011 to February 2015 were randomly divided into experimental group and control group with 60 cases each. The experimental group received spermatic vein ligation under microscope, and the control group received traditional open high ligation. The diameter of spermatic vein, the reflux time of spermatic vein, the blood flow value of testicular capsule artery and semen quality were compared between the two groups before and after operation. Results: the comparison between groups showed that, The time of spermatic vein reflux in the trial group was significantly shorter than that in the control group 3 months after operation [0.41 卤0.1 vs(1.08 卤0.1 vs(1.08 P 0.05]. The maximum internal diameter of the spermatic vein in the trial group was higher than that in the control group in the resting Valsalva state 3 months after operation [1.63 卤0.07)mm vs(1.59 卤0.06 卤1.72 卤0.07 0.05)mm vs(1.68, P < 0.05]. The maximal systolic velocity of testicular capsule artery in the experimental group was 9.26 卤1.35 vs 10.64 卤1.28 (P 0.05) and the vascular resistance index (RI) was 0.52 卤0.03 vs 0.61 卤0.03P 0.05, which was significantly lower than that in the control group. Three months after operation, the sperm concentration (46.84 卤5.24) 脳 106/ml vs(35.35 卤4.26 脳 10 6 / ml / ml (P 0.05), sperm motility [63.75 卤7.73)%vs(53.87 卤6.46%] and total sperm count (89.54 卤7.95 脳 106/ml vs(75.24 卤8.43) 脳 10 6 / ml P0.05] in the trial group were higher than those in the control group. Conclusion: the results of this study show that the effect of spermatic vein ligation under microscope is definite, which can effectively improve testicular blood flow and semen quality, and is worth popularizing clinically.
【作者单位】：四川省医学科学院/四川省人民医院泌尿外科;
【基金】：四川省卫生计生委科研课题(090458) 四川省医学甲级重点学科(泌尿外科)建设项目(CZ91-02)~~
【分类号】：R699.8

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