摘要
[目的]观察腹腔镜下高选择性高位结扎精索静脉治疗精索静脉曲张的临床疗效.[方法]本院收治Ⅱ度以上原发性精索静脉曲张患者82例分为两组,其中行腹腔镜下保留精索动脉及淋巴组织的高选择性精索静脉高位结扎术（A组）40例（合并不育17例）,行腹腔镜下精索血管集束结扎术（B组）42例（合并不育18例）.统计分析两组手术时间、术后鞘膜积液、睾丸萎缩、复发及精液改善和生育情况等.[结果]82例手术均成功,术后随访2年.两组手术时间分别为（43.0±9.7）min和（20.4±6.9）min,鞘膜积液发生率分别为0（0/40）和14.3%（6/42）,睾丸萎缩发生率分别为0 （0/40）和9.5%（4/42）,术后3个月精液质量提高率分别为80%（32/40）和59.5%（25/42）,术后2年配偶自然怀孕率分别为64.7%（11/17）和33.3%（6/18）,以上指标组间比较差异均有统计学意义（P〈0.05）.两组患者复发率分别为5%（2/40）和4.7%（2/42）,差异无统计学意义（P〉0.05）.[结论]腹腔镜下保留精索动脉的高选择性高位结扎精索静脉术,其术后并发症发生率低,精液质量提高率和术后配偶自然怀孕率高,值得临床推广.
[Objective]To observe the clinical efficacy of laparoscopic high selective ligation of spermatic vein for the treatment of varicocele. [Methods]Totally 82 cases with primary varicocele above grade Ⅱ in our hospital were randomly divided into 2 groups. Group A（ n=40, 17 with infertility） underwent laparoscopic high selective ligation of spermatic vein with spermatic artery and lymph tissue preservation. Group B（ n=42, 18 with infertility） underwent laparoscopic cluster ligation of spermatic vessels. The operation time, postoper ative hydrocele, testicular atrophy, recurrence, sperm improvement and fertility were analyzed statistically. [Results] All 82 cases operated successfully, and then were followed up for 2 years after operation. The operation time of two groups were （43.0±9.7）minand （20.4±6.9）min, respectively. The incidence ofhydrocele in two groups were 0（0/40） and 14. 3%（6/42）, respectively. The incidence of testicular atrophy in two groups were 0（0/40） and 9.5%（4/42）, respectively. The improvement of semen quality in 3 months after op eration in two groups were 80% （32/40） and 59.5% （25/42）, respectively. The spontaneous pregnant rates of his spouses in 2 years after operation in two groups were 64.7%（11/17） and 33.3%（6/18）, respectively. There were significant differences in above indexes between two groups（P〈0.05）. The recurrence rate of two groups were 5% （2/40） and 4. 7%（ 2/42 ）, respectively, and there was no significant difference between two groups（ P〉0.05）. [Conclusion] Laparoscopic high selective ligation of spermatic vein with spermatic artery preservation has low incidence of complications, high improvement rate of semen quality and spontaneous pregnant rate of spouse. It is worth to be extended in clinics.
出处
《医学临床研究》
CAS
2011年第2期238-240,共3页
Journal of Clinical Research
