论文部分内容阅读
目的:评价高选择性腹腔镜精索静脉高位结扎术在精索静脉曲张患者治疗中的临床疗效和安全性,并与腹腔镜精索血管集束结扎术进行比较。方法:回顾性分析2011年7月~2013年6月期间共60例Ⅱ度以上精索静脉曲张患者。按手术方法式分为两组,其中,高选择性腹腔镜精索静脉高位结扎术30例(A组),腹腔镜精索血管集束结扎术30例(B组),统计学分析两组手术时间、术后并发症、术后精液质量改善等情况。结果:60例手术均成功,术后随访6个月。A组、B组手术时间分别为(41.3±9.8)min、(25.7±8.1)min;共出现手术并发症5例,其中A组发生1例阴囊水肿(3.3%,1/30),B组发生1例附睾炎、3例阴囊水肿(13.3%,4/30),术后并发症的发生率两组间差异具有统计学意义(P<0.05)。两组间精索静脉曲张复发率分别为6.7%(2/30)和3.3%(1/30),两组间差异无统计学意义(P>0.05)。术后6个月复查精液质量改善率,A、B组分别为73.3%(22/30)和60%(18/30),两组间差异具有统计学意义(P<0.05)。结论:与腹腔镜精索血管集束结扎术相比,高选择性的精索静脉高位结扎术疗效好,术后并发症发生率低,是值得推广的安全有效的手术方式。
Objective: To evaluate the clinical efficacy and safety of high-selective laparoscopic varicocele in the treatment of varicocele and to compare with laparoscopic laparoscopic suture. Methods: A total of 60 patients with grade Ⅱ varicocele from July 2011 to June 2013 were retrospectively analyzed. According to the surgical method, the patients were divided into two groups: 30 cases (group A) with high selective laparoscopic varicocele ligation and 30 cases (group B) with laparoscopic laparoscopic vascular bundle ligation. Time, postoperative complications, postoperative sperm quality improvement and so on. Results: All 60 cases were successful and were followed up for 6 months. The operative time in group A and group B were (41.3 ± 9.8) min and (25.7 ± 8.1) min, respectively. There were 5 cases of surgical complications including 1 case of scrotal swelling (3.3%, 1/30) in group A, One case had epididymitis and three cases had scrotal edema (13.3%, 4/30). The incidence of postoperative complications was statistically significant between the two groups (P <0.05). The recurrence rates of varicocele between the two groups were 6.7% (2/30) and 3.3% (1/30) respectively, with no significant difference between the two groups (P> 0.05). The improvement rate of sperm quality at 6 months after operation was 73.3% (22/30) and 60% (18/30) in group A and B, respectively. The difference between the two groups was statistically significant (P <0.05). Conclusion: Compared with laparoscopic spermatic bundle ligation, high selective spermatic vein ligation is effective and the incidence of postoperative complications is low, which is a safe and effective surgical method worthy of promotion.