摘要
目的:研究不同方式精索静脉曲张(VC)结扎术对患者精液质量的影响及安全性。方法:纳入因不育症或阴囊不适接受手术治疗的VC患者78例,其中显微镜下VC结扎术42例作为A组,腹腔镜下VC结扎术36例作为B组。对手术前后两组患者精液质量进行评估,比较手术前后两组患者睾丸内动脉血流参数,对两组患者进行为期1年的随访,比较两组并发症发生情况。结果:手术后,与手术前相比,A组和B组的精子活率、精子密度和活动精子总数均明显增高(P<0.05),其中手术后A组精子活率和活动精子总数明显高于B组(P<0.05),两组精子密度相比,差异无统计学意义(P>0.05)。手术后,与手术前相比,A组和B组睾丸内动脉血流参数阻力指数(RI)和搏动指数(PI)均明显降低(P<0.05),舒张末期流速(EDV)明显增高(P<0.05)。手术后,与A组相比,B组RI明显较高(P<0.05),EDV明显较低(P<0.05),两组PI相比,差异无统计学意义(P>0.05)。两组睾丸疼痛、阴囊水肿和附睾炎的发病率相比,差异无统计学意义(P>0.05)。结论:腹腔镜和显微镜手术均能够明显改善VC患者的精液质量和睾丸内动脉血流,安全性好,其中显微镜手术的疗效更佳。
Objective:To study the effect of different methods of varicocele ligation on semen quality and safety analysis.Methods:78 patients with VC who were admitted to our hospital for infertility or scrotal discomfort were treated.42 cases of VC ligation under microscope were used as group A,and 36 cases of laparoscopic VC ligation were used as group B.The semen quality of the two groups before and after surgery were compared.The blood flow parameters of the testicular arteries in the two groups before and after surgery were compared.The two groups of patients were followed up for 1 year,and the complications of the two groups were compared.Results:After operation,the sperm motility,sperm density and total number of active spermatozoa in group A and group B were significantly higher than those before surgery(P<0.05).After operation,the sperm motility and the total number of sperm in group A were significantly higher than those in group B(P<0.05).There was no significant difference in sperm density between the two groups(P>0.05).After operation,compared with preoperative,the parameters of RI and PI in the testicular blood flow of group A and group B were significantly decreased(P<0.05),and EDV was significantly increased(P<0.05).After surgery,compared with group A,group RI was significantly higher(P<0.05)and EDI was significantly lower(P<0.05).There was no significant difference in PI(P>0.05).There was no significant difference in the incidence of testicular pain,scrotal edema and epididymitis between the two groups(P>0.05).Conclusion:Both laparoscopic and microscopic surgery can significantly improve the semen quality and intratesticular arterial blood flow in patients with VC.The efficacy of microsurgery is better,which is worthy of popularization in clinical practice.
作者
孙文
SUN Wen.(Urology Surgery,Hunan Yiyang Kangya Hospital(Yiyang 413000))
出处
《陕西医学杂志》
CAS
2019年第10期1292-1294,1304,共4页
Shaanxi Medical Journal
基金
湖南省自然科学基金资助项目(S2016J504B)
