摘要
目的探究经腹股沟或经腹膜后精索静脉高位结扎与显微镜下精索静脉低位结扎治疗精索静脉曲张的疗效比较.方法选取2015年8月至2018年3月在本院接受治疗的精索静脉曲张患者90例为研究对象,根据不同手术方式将患者分为三组,分别是A组(经腹股沟精索静脉高位结扎术)、B组(经腹膜后精索静脉高位结扎术)以及C组(显微镜下精索静脉低位结扎术),每组30例.比较三组患者的手术时间、出血量、术后当天温度、住院时间、精子质量、术后并发症及复发情况等.结果C组的手术时间显著长于A、B组,且差异具有统计学意义(P<0.05);出血量、术后当天温度以及住院时间三组差异无统计学意义(P>0.05);术后1年三组的各项精子质量指标均显著高于术前,差异具有统计学意义(P<0.05),同时C组的各项指标质量显著高于A、B组(P<0.05);C组的术后2h切口疼痛感明显好于A组和B组(P<0.05);C组的术后并发症发生率10%显著低于A组的40%和B组的33.3%(P<0.05);三组的疾病复发情况差异无统计学意义(P<0.05).结论显微镜下精索静脉低位结扎术对于治疗精索静脉曲张相较于经腹股沟或经腹膜后精索静脉高位结扎术,其改善精子质量效果更好,并发症发生情况低,安全性更高,是值得进一步推广的手术方式.
Objective To investigate the therapeutic effect of varicocele treated with high liga-tion of the inguinal or retroperitoneal varicocele and microsurgical ligatures vein ligation. Methods A retrospective analysis of 90 patients with varicocele treated in our hospital from August 2015 to March 2018 was conducted. The patients were divided into three groups according to the different surgical methods. They were group A (surgical methods:High inguinal varicocele ligation), group B (surgical method:high retroperitoneal varicocele ligation ) and group C ( surgical method: microsurgical liga-tures vein ligation), 30 cases in each group. The operative time, blood loss, postoperative day tem-perature, length of hospital stay, sperm quality, postoperative complications, and recurrence of the three groups were compared. Results The operation time of group C was significantly longer than that of group A and B, and the difference was statistically significant(P<0. 05). The difference of bleed-ing volume, postoperative day temperature and length of stay was similar(P>0. 05). One year after operation, the sperm quality indicators of the three groups were significantly higher than before surger-y, and the difference was statistically significant (P<0. 05). At the same time, the quality of each index in group C was significantly higher than that of group A and B(P<0. 05). The group C of the 2 h incision pain was significantly better in group A and group B(P<0. 05). The incidence of postoper-ative complications in group C was significantly lower than that in group A (40%) and group B (33. 3%)(P<0. 05). The difference in disease recurrence between the three groups was not statistically significant(P<0. 05). Conclusions Microsurgical ligatures vein ligation for the treatment of varico-cele compared to the inguinal or retroperitoneal varicocele ligation, its effect on improving sperm quali-ty is better, the incidence of complications is low, the safety is higher , is worthy of further promotion of surgical methods.
作者
李乾
姜福金
刘鑫
李强
王磊
Li Qian;Jiang Fujin;Liu Xin;Li Qiang;Wang Lei(Department of Urology,the Second People's Hospital of Huaian City,Huaian 223002,China;Department of Qncology,the 82nd Hospital of the Chinese People's Liberation Army,Huaian 223000,China)
出处
《国际泌尿系统杂志》
2019年第4期682-685,共4页
International Journal of Urology and Nephrology
