摘要
目的分析比较在精索静脉曲张(varicocele,VC)治疗中腹腔镜和显微镜下进行手术的治疗效果及对精液质量及激素分泌的影响。方法随机选择2019年2月—2021年12月解放军联勤保障部队第910医院收治的200例患者作为研究对象,按入院先后顺序分组,各100例。观察组采用显微镜精索静脉结扎术治疗,对照组行腹腔镜精索静脉高位结扎术治疗,比较两种术式差异及对患者术后并发症的影响。结果观察组术中出血量(11.29±1.68)mL少于对照组,差异有统计学意义(t=29.892,P<0.05)。观察组住院时间(2.67±0.88)d短于对照组,差异有统计学意义(t=13.284,P<0.05)。术前比较,两组患者精液质量和激素水平,差异无统计学意义(P>0.05);术后比较,观察组精液质量明显高于观察组,精液密度(40.36±4.69)×10^(6)/mL、精子活动率(48.77±5.21)%、精液量(3.98±0.99)mL均高于对照组,差异有统计学意义(t=8.835、11.267、5.212,P<0.05)。观察组T水平(7.2±0.5)μg/L高于对照组,差异有统计学意义(t=14.084,P<0.05)。观察组FSH水平(3.6±0.3)U/L、LH水平(4.7±0.8)U/L明显低于对照组,差异有统计学意义(t=15.756、9.407,P<0.05)。术后,观察组并发症发生率(3.00%)低于对照组(11.00%)(χ^(2)=4.916,P<0.05)。结论显微镜手术治疗VC相较于腹腔镜治疗可以减少不良反应的发生,提高患者精液质量、改善激素水平,疗效显著。
Objective To analyze and compare the therapeutic effects of laparoscopy and microscopic surgery in the treatment of varicocele(VC)and the impact on semen quality and hormone secretion.Methods 200 patients admitted to the hospital from February 2019 to December 2021 were randomly selected.Grouped according to the order of ad⁃mission,100 cases each.The observation group was treated with microscopic spermatic vein ligation,and the control group was treated with laparoscopic high ligation of spermatic vein.The differences between the two surgical methods and their impact on postoperative complications were compared.Results The intraoperative bleeding volume(11.29±1.68)mL in the observation group was lower than that in the control group,and the difference was statistically signifi⁃cant(t=29.892,P<0.05).The hospitalization time of the observation group(2.67±0.88)days was shorter than that of the control group,and the difference was statistically significant(t=13.284,P<0.05).Before surgery,there was no sta⁃tistically significant difference in semen quality and hormone levels between the two groups of patients(P>0.05);after surgery,the quality of semen in the observation group was significantly higher than that in the observation group,with a semen density of(40.36±4.69)×10^(6)/mL,sperm activity rate(48.77±5.21)%,and semen volume(3.98±0.99)mL were all higher than the control group,and the difference was statistically significant(t=8.835,11.267,5.212,P<0.05).Ob⁃servation group T level(7.2±0.5)μg/L was higher than the control group,and the difference was statistically signifi⁃cant(t=14.084,P<0.05).The levels of FSH(3.6±0.3)U/L and LH(4.7±0.8)U/L in the observation group were signifi⁃cantly lower than those in the control group,and the difference was statistically significant(t=15.756,9.407,P<0.05).After surgery,the incidence of complications in the observation group(3.00%)was lower than that in the control group(11.00%)(χ^(2)=4.916,P<0.05).Conclusion Compared with laparoscopic treatment,microscopic surgery for VC can re⁃duce the incidence of adverse reactions,improve the quality of semen and improve hormone levels,and has a signifi⁃cant effect,which is worthy of application.
作者
洪梓煌
张剑平
潘润阳
HONG Zihuang;ZHANG Jianping;PAN Runyang(Department of Urology,the 910th Hospital of the PLA Joint Logistics Support Force,Quanzhou,Fujian Province,362000 China)
出处
《中外医疗》
2023年第2期32-36,共5页
China & Foreign Medical Treatment
