摘要
目的:探讨不同术式精索静脉曲张手术对改善精液质量的影响。方法:2013年2月-2014年6月收治精索静脉曲张者90例,所有患者均经B超确诊,随机分成显微手术、腹腔镜手术和腹膜后高位结扎术3组,每组30例,显微手术组采用连续硬膜外麻醉,于腹股沟管外环下方1~2 cm切口,逐步分离出精索静脉,5-0丝线断扎;腹腔镜手术组采用全身麻醉,应用腹腔镜经腹途径,打开腹膜后于腹股沟内环水平断扎精索静脉;腹膜后高位结扎术组采取腰麻,于高位结扎选取经典的腹股沟管上方切口,在腹膜后断扎精索静脉。结果:3组患者手术前后正常形态精子比率、活动精子数、HOS比率、有效精子数、活动率、精子密度、(A+B)级精子比率明显提高,手术前后比较差异有统计学意义(P<0.05),显微手术组术后明显优于腹腔镜手术组和腹膜后高位结扎术组(P<0.05)。结论:显微手术治疗精索静脉曲张创伤小,明显提高患者的精液质量,临床疗效显著,值得推广。
Objective:To discuss the influence of different surgical varicocele to improve semen quality.Methods:90 patients with varicocele were selected from February 2013 to June 2014.All patients were diagnosed by B-ultrasound.They were randomly divided into the micro-surgery group,the laparoscopic surgery group and the peritoneum high ligation group with 30 cases in each group.The micro-surgery group were given continuous epidural anesthesia,on the outer ring of the inguinal canal below the 1~2cm incision,we gradually separated the spermatic vein,with 5-0 silk tie break;the laparoscopic surgery group were given general anesthesia,laparoscopic transabdominal approach was used,after opening the peritoneum,we tied the spermatic vein at the internal inguinal ring level;the peritoneum high ligation group were given spinal anesthesia,we chose the classic high ligation incision above the inguinal canal,in the tie break retroperitoneal spermatic vein.Results:In 3 groups of patients before and after surgery,the ratio of normal sperm morphology,motile sperm count,HOS rate,effective sperm count,motility,sperm concentration,(A + B)level spermatozoa were significantly improved,and there was statistically significant(P<0.05).The micro-surgery group was significantly better than the laparoscopic group and peritoneum high ligation group(P<0.05).Conclusion:The trauma of microsurgical treatment of varicocele was small.It could significantly improve semen quality.Clinical effect was significant.It was worth promoting.
出处
《中国社区医师》
2015年第8期50-51,共2页
Chinese Community Doctors
关键词
精索静脉曲张
不同术式
精液质量
Varicocele
Different surgical procedures
Semen quality
