摘要
目的:探讨局麻下显微精索内静脉结扎术用于日间手术模式的安全性和有效性。方法:回顾性分析长江大学附属第一医院泌尿男科2018年4月-2019年12月收治的100例原发性精索静脉曲张(VC)患者资料,按照住院模式不同分为日间手术组(研究组)50例和常规手术组(对照组)50例。研究组患者日间手术模式下行显微精索静脉结扎术,对照组患者行局麻下常规手术。1周后复诊,随访记录至术后12个月,比较并分析不同住院模式的住院费用及手术效果。结果:全部手术均在局麻下完成,术中疼痛评分(2.8±0.6)分,术后4 h疼痛评分(3.1±0.8)分,均为可耐受水平;住院费用研究组为(6618±267)元,对照组为(8835±312)元,日间手术组住院费用明显低于常规手术组,差异有统计学意义(P<0.05)。术后研究组伤口脂肪液化1例,对照组阴囊水肿1例。随访1年,两组均有1例失访,未见并发症发生及复发者,精液质量改善研究组33例(73.3%),对照组32例(71.1%),阴囊不适症状改善研究组39例(88.6%),对照组37例(88.1%),两组差异无统计学意义(P>0.05)。结论:局麻下显微精索静脉结扎术应用于日间手术安全、疗效确切,且有局麻下操作、住院时间短、费用低的优点,下一步可加大样本量行随机对照研究为开展VAC日间手术模式提供更多循证医学证据。
Objective:To explore the safety and effectiveness of microsurgical ligation of spermatic vein under local anesthesia in daytime operation.Methods:Retrospective analysis was performed on 100 patients with primary varicocele(VC)admitted to the Urology Department of the First Affiliated Hospital of Yangtze University from April 2018 to December 2019.According to different modes of hospitalization,50 patients served as the daytime operation group(study group)and 50 patients as the conventional operation group(control group.Patients in the study group were treated with micro VC ligation in daytime operation mode,and those in the control group underwent the routine operation under local anesthesia.The patients were followed up at 1 st week to the 12 th month after the operation.The hospitalization costs and surgical effects of different hospitalization modes were compared and analyzed.Results:All the surgeries were performed under local anesthesia.The intraoperative pain score was(2.8±0.6),and the pain score at 4 th h after operation was(3.1±0.8),and both were tolerable levels.Hospitalization costs in the study group were significantly lower than those in the control group(6618±267 vs.8835±312 Yuan RMB,P<0.05).One case of complication occurred in both groups at 1 st week after operation.After one year of follow up,one case was lost in both groups,and no complications or recurrence were found.There were 33 cases(73.3%)of semen quality improvement in the study group,32 cases(71.1%)in the control group;39 cases(88.6%)of scrotal discomfort improvement in the study group,and 37 cases(88.1%)in the control group.There was no statistically significant difference between the two groups(P>0.05).Conclusion:Microsurgical ligation of spermatic vein under localanesthesia is safe and effective in daytime operation,and it has the advantages of operation under local anesthesia,short hospital stay and low cost.The next step is to increase the sample size and conduct randomized controlled studies to provide more evidence-based medical evidence for the daytime operation of VC.
作者
黄健
熊存锦
唐喆
龚小波
钟光俊
熊鹰
HUANG Jian;XIONG Cunjin;TANG Zhe;GONG Xiaobo;ZHONG Guangjun;XIONG Ying(Department of Urology,the First Affiliated Hospital of Yangtze University,Jingzhou 434000,China)
出处
《微创泌尿外科杂志》
2021年第2期129-132,共4页
Journal of Minimally Invasive Urology
作者简介
通信作者:熊鹰,31350266@qq.com
