精索静脉曲张4种手术方式临床疗效比较

发布时间：2018-10-10 09:42

【摘要】：目的:探讨精索静脉曲张4种常见手术方式的临床疗效。方法:回顾性总结318例精索静脉曲张患者术前以及术后临床资料,其中经腹股沟管精索静脉结扎术108例,腹膜后精索静脉结扎术(Palomo术)84例,腹腔镜精索静脉结扎术68例,显微镜下精索静脉结扎术58例。比较不同手术方式在手术时间、住院天数、术前以及术后精子活力与浓度、并发症发生率、复发率和精子质量改善率等的不同。结果:经腹股沟管组、Palomo术组、腹腔镜组以及显微镜组的手术时间分别为(50.3±13.9)、(70.4±14.3)、(35.1±11.1)、(65.3±13.2)min,其中腹腔镜组耗时明显少于其他3组(P0.05)。4组的住院天数分别为(6.3±1.6)、(5.7±1.5)、(4.3±1.4)、(3.4±1.3)d,其中显微镜组住院天数明显少于其他3组(P0.05)。在并发症发生率、术后超声精索静脉返流发生率以及复发率方面,显微镜组均明显低于其他3组(P均0.05)。4组术后精子浓度与活力较术前均有改善,而精子质量改善率,显微镜组明显高于其他3组(P0.05)。结论:与经腹股沟管精索静脉手术、Palomo术以及腹腔镜技术相比,显微镜手术具有并发症少、精子质量改善率高,住院时间短等优势,适合在基层推广开展。
[Abstract]:Objective: to investigate the clinical effect of four common surgical methods of varicocele. Methods: the clinical data of 318 patients with varicocele before and after operation were reviewed retrospectively, including 108 cases of spermatic vein ligation via inguinal canal, 84 cases of retroperitoneal varicocele ligation (Palomo) and 68 cases of laparoscopic varicocele ligation. Microscopical varicocele ligation was performed in 58 cases. The time of operation, the days of hospitalization, the sperm motility and concentration before and after operation, the incidence of complications, the recurrence rate and the improvement rate of sperm quality were compared. Results: Palomo operation group, The operative time of laparoscopy group and microscope group were (50.3 卤13.9), (70.4 卤14.3), (35.1 卤11.1), (65.3 卤13.2) min,. The duration of hospitalization in laparoscopy group was significantly shorter than that in other three groups (P0.05). The hospitalization days in the microscope group were (6.3 卤1.6), (5.7 卤1.5), (4.3 卤1.4), (3.4 卤1.3) days, and the hospitalization days in the microscope group were significantly less than those in the other three groups (P0.05). In the incidence of complications, the incidence and recurrence rate of ultrasonic varicocele vein reflux, the sperm concentration and motility in the microscope group were significantly lower than those in the other three groups (P 0.05), but the sperm quality was improved. The microscope group was significantly higher than the other three groups (P0.05). Conclusion: compared with Palomo via inguinal vein operation and laparoscopy, microscopical surgery has less complications, higher sperm quality improvement rate and shorter hospitalization time, so it is suitable to be popularized at the basic level.
【作者单位】：广州市白云区第一人民医院泌尿外科;广州中山大学附属第六医院超声科;
【分类号】：R699.8

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