摘要
目的探讨应用术前彩色多普勒超声观测精索内睾丸动脉数量的准确性及应用价值,为精索静脉结扎手术起到安全指导作用,以便最大限度保护睾丸功能。方法选取2020年8月至2021年5月大连医科大学附属第一医院诊治的91例精索静脉曲张患者作为研究对象。术前应用彩色多普勒超声,在手术侧精索切口处准确区分精索内部结构,记录并观察睾丸动脉数量,与术中最终实际探查的动脉数量作比较。同时观察睾丸动脉、输精管动脉的收缩期峰值流速以及动脉阻力指数。结果91例患者均顺利完成手术,共进行107根精索的结扎手术,术前超声判定的精索内睾丸动脉数量与术中实际数量吻合的为96根精索,另外11根不一致。采用Kappa一致性检验,K值为0.810,两者一致性较好,差异具有统计学意义(P<0.05)。输精管动脉与睾丸动脉的收缩期峰值流速、内径比较,差异具有统计学意义(P<0.05)。输精管动脉与睾丸动脉的动脉阻力指数比较,差异无统计学意义(P>0.05)。结论通过术前超声可准确识别精索内睾丸动脉数量,并且能区分睾丸动脉及输精管动脉,对保留睾丸动脉的低位精索静脉切断术起到指导作用,可提高手术效率,避免术中误伤睾丸动脉。
Objective To explore the accuracy and application value of preoperative color Doppler ultrasound observation of the number of testicular arteries in the spermatic cord,provide safety guidance for the varicocelectomy,and protect the testicular function to the maximalextent.Methods 91 patients with varicocele treated in the First Affiliated Hospital of Dalian Medical University from August 2020 to May 2021 were selected as subjects.Before surgery,color Doppler ultrasound was used to accurately distinguish the internal structure of the spermatic cord at the operative side of the spermatic cord incision,and the number of testicular arteries was recorded and observed,and compared with the actual number of intraoperative arteries.At the same time,the peak systolic velocity and arterial resistance index of testicular artery and vas deferens artery were observed.Results All 91 patients included in the study successfully completed the operation.A total of 91 patients underwent ligation of 107 spermatic cords.The number of testicular arteries in the spermatic cord determined by preoperative ultrasound was consistent with the actual number during the operation,which was 96 spermatic cords,the other 11 spermatic cords are inconsistent.The Kappa consistency test was performed,and the result was:K value was 0.810,indicating that the consistency was good,which had statistical significance(P<0.05).There is a significant difference in the peak systolic velocity and vessel diameter between the testicular artery and deferential artery,which had statistically significant(P<0.05).There was no significant difference in arterial resistance index between testicular artery and vas deferens artery(P>0.05).Conclusions Preoperative ultrasound evaluation can accurately identify the internal structure of the spermatic cord,distinguish between the testicular artery and deferential artery,and play a guiding role in the microscopic varicocelectomy with the preservation of the testicular artery,improve the operation efficiency,and avoid the injur
作者
谢文龙
姜涛
郭立英
车颖
XIE Wenlong;JIANG Tao;GUO Liying;CHE Ying(Department of Ultrasound,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,Liaoning,China;Department of Andrology,the First Affiliated Hospital ofDalian Medical University,Dalian 116011,Liaoning,China)
出处
《中国性科学》
2022年第3期28-32,共5页
Chinese Journal of Human Sexuality
