摘要
目的:对比显微镜下左精索-腹壁下静脉分流术与显微镜下精索静脉高位结扎术在胡桃夹征(NCS)并精索静脉曲张(VC)中的疗效。方法:回顾性分析2015-2019年收治98例确诊为NCS合并VC患者的临床资料,根据手术方式不同将患者分为分流组(行显微镜下左精索-腹壁下静脉分流术,53例),结扎组(行显微镜下精索静脉高位结扎术,45例)。所有患者于术前、术后查尿常规、精液常规、阴囊彩超、左肾静脉彩超等。结果:分流组23例血尿患者中18例(78.3%)治愈(P<0.001),19例蛋白尿患者中15例(78.9%)尿蛋白消失(P<0.001),结扎组与术前相比差异无统计学意义(P>0.05)。在精子浓度、活力方面两组均有明显疗效(P<0.05)。在NCS相关指标上,特别是左肾静脉(LRV)受压狭窄处最高流速、狭窄处最高流速/扩张处最高流速,分流组较术前有明显疗效(P<0.001)。分流组术后指标亦明显优于结扎组(P≤0.001)。结论:显微镜下左精索-腹壁下静脉分流术较显微镜下精索静脉高位结扎术在NCS合并VC的治疗中更为安全、有效。
Objective:To compare the curative effects of microsurgical spermatic-inferior epigastric vein anastomosis and microsurgical spermatic vein high ligation for varicocele(VC)complicated by nutcracker syndrome(NCS).Methods:We retrospectively analyzed the clinical data of 98 cases of VC treated by surgery in our hospital from 2015 to 2019.According to different surgical procedures,the patients were divided into microsurgical spermatic-inferior epigastric vein anastomosis group(n=53)and microsurgical spermatic vein high ligation group(n=45).Urine routine,semen routine,scrotal ultrasound and left renal vein(LRV)color ultrasound were examined in all of the patients before and after operation.Results:In the microsurgical spermatic-inferior epigastric vein anastomosis group,hematuria was cured in 18 of 23 cases(78.3%)(P<0.001),while proteinuria disappeared in 78.9%(15/19)cases(P<0.001).In the microsurgical spermatic vein high ligation group,the incidence of hematuria and proteinuria remained unchanged(P>0.05).Semen density and viability were significantly improved in both two groups(P<0.05).The indexes about NCS in the microsurgical spermatic-inferior epigastric vein anastomosis group,especially the LRV peak velocity and the mean peak velocities ratio in upright posture,were obviously ameliorated as compared with those preoperation(P<0.001).Likewise,the indexes about NCS in the microsurgical spermatic-inferior epigastric vein anastomosis group were significantly better than in the microsurgical spermatic vein high ligation group(P≤0.001).Conclusion:Microsurgical spermatic-inferior epigastric vein anastomosis was more effective than microsurgical spermatic vein high ligation in the treatment of NCS complicated with VC.
作者
陈建帆
赖彩永
郭泽雄
韩键
黎明珠
孔国权
李宇同
卓育敏
CHEN Jianfan;LAI Caiyong;GUO Zexiong;HAN Jian;LI Mingzhu;KONG Guoquan;LI Yutong;ZHUO Yumin(Department of Urology,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Department of Vascular Surgery,the First Affiliated Hospital of Jinan University;Depart⁃ment of Ultrasound,the First Affiliated Hospital of Jinan University)
出处
《微创泌尿外科杂志》
2021年第4期251-256,共6页
Journal of Minimally Invasive Urology
作者简介
通讯作者:卓育敏,tzhuoyumin@126.com
