摘要
目的：探讨显微镜腹股沟下与经脐单孔腹腔镜高位结扎治疗精索静脉曲张的疗效差异。方法共218例患者，按数字表法随机分为两组，一组148例行显微镜腹股沟斜切口精索静脉结扎术（显微镜组），另一组70例行经脐单孔腹腔镜精索静脉高位结扎术（单孔腹腔镜组）。术后随访3-24个月，比较两组手术时间、住院时间、住院费用、手术并发症和手术前后精液质量参数的变化。结果两组手术并发症、手术时间、住院费用差异有统计学意义（均 P 〈0．05），两组患者住院时间差异无统计学意义（P 〉0．05）。218例随访患者，术前显微镜组和单孔腹腔镜组精子密度及活力[（a ＋b）％]分别为（19．1±8．2）×10^6／mL、（18．2±7．9）×10^6／mL 和（22．7±7．8）％、（21．6±8．9）％，术后3-6个月显微镜组及单孔腹腔镜组分别为（56．2±10．8）×10^6／mL、（45．8±12．9）×10^6／mL 和（58．8±9．7）％、（44．6±10．7）％，较术前显著改善（t ＝6.227、9.579，均 P 〈0．05）。结论两种手术方法都能提高患者的精液质量参数。但显微镜组在精液质量参数改善、安全性、患者依从性及经济性考虑明显优于经脐单孔腹腔镜组。
Objective To compare the clinical efficacy of subinguinal microsurgical and single -port laparoscopic high ligation in the treatment of varicocele.Methods 218 patients with varicocele were enrolled in this study.According to the digital table,they were randomly divided into two group.148 cases were treated by subinguinal microscopic varicocelectomy（microscopic group）,70 cases were treated by single -port laparoscopic high ligation varicocele（single -port laparoscopic group）.Postoperative follow up was 3 -24months.The operative duration,length of hospital stay,hospitalization expense,postoperative complications and semen quality parameters were compared between the two groups.Results There were statistically significant differences in operative duration and hospitalization expense between the two groups（all P 〈0.05）.There was no statistically significant difference in length of hospital stay （P 〉0.05）.In the 218 followed -up patients,the sperm concentration and motility （grade a ＋ b sperm）all significantly improved,which of the microscopic group and single -port laparoscopic group preoperation were （19.1 ± 8.2）×10^6 /mL,（18.2 ±7.9）×10^6 /mL and （22.7 ±7.8）%,（21.6 ±8.9）% respectively,which at 3 -6 months after operation were （56.2 ±10.8）×10^6 /mL,（45.8 ±12.9）×10^6 /mL and （58.8 ±9.7）%,（44.6 ±10.7）%, there were statistically significant differences compared with preoperation （t =6.227,9.579,all P 〈0.05 ）. Conclusion The surgical methods in the treatment of varicocele can improve the quality of patients,but microscopic group is obviously better than single -port laparoscopic group in improvement of semen quality parameters,safety, patient -based compliance and economy.
作者
杨志国
姬广丽
苗发陈
任庆芹
张波
马勇
黄诗桥
Yang Zhiguo Ji Guangli Miao Fachen Ren Qingqin Zhang Bo Ma Yong Huang Shiqiao(Department of Urology, the Central Hospital of Shan County, Shandong 274300, Chin)
出处
《中国基层医药》
CAS
2017年第5期763-766,共4页
Chinese Journal of Primary Medicine and Pharmacy
