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目的分析400例精索静脉曲张(VC)患者的临床治疗方法,对比3种手术方式的疗效。方法选取东莞三局医院2005年1月-2015年12月收治的400例VC手术患者,主要是Ⅱ度及以上的精索静脉曲张有症状患者或者是Ⅱ度及以上的男性不育症患者,按手术方法分为3组:精索静脉高位结扎术为A组、腹腔镜和显微镜下手术分别为B组、C组。比较3组治疗效果。结果手术时间方面C组多于B组多于A组;术后住院时间C组少于B组少于A组;住院费用C组少于A组少于B组,差异均有统计学意义(P<0.01)。A组、B组、C组并发症率分别为14.48%、10.87%、2.56%,复发率分别为10.34%、8.70%、1.71%,C组均明显低于A组、B组,差异均有统计学意义(P<0.05),精液质量改善率分别为37.93%、47.83%、63.25%,C组明显高于A组、B组,差异有统计学意义(P<0.05),A组和B组间比较,差异均无统计学意义(P>0.05)。结论显微镜下精索静脉高位结扎术创伤小,术后恢复快,并发症和复发率低,精液质量改善效果好,值得在临床推广。
Objective To analyze the clinical treatment of 400 patients with varicocele (VC) and compare the curative effects of the three surgical methods. Methods A total of 400 patients undergoing VC surgery admitted to the Third Hospital of Dongguan from January 2005 to December 2015 were selected. The patients with symptoms of varicocele Ⅱ and above or male infertility with grade Ⅱ or higher were included. Surgical methods were divided into 3 groups: high varicocele ligation group A, laparoscopic and microscopic surgery were B group, C group. Compare the 3 groups treatment effect. Results The operation time of C group was more than that of B group than that of A group. The length of postoperative hospital stay was less in group C than in group B, while the cost of hospitalization in group C was less than that in group A, but the difference was statistically significant ( P <0.01). The complication rates in group A, group B and group C were 14.48%, 10.87% and 2.56%, respectively, and the recurrence rates were 10.34%, 8.70% and 1.71% respectively in group A, B and C (P <0.05). The improvement rates of semen quality were 37.93%, 47.83% and 63.25% respectively, which were significantly higher in group C than those in group A and group B. The difference was statistically significant (P <0.05) There was no significant difference between the two groups (P> 0.05). Conclusion High varicocele ligation under the microscope is less traumatic, quick recovery after operation, low complication rate and recurrence rate, good semen quality improvement and worthy of clinical promotion.