摘要
目的 提高腹腔镜下手术治疗精索静脉曲张水平.方法 2003年7月至2007年10月收治Ⅱ度以上原发性精索静脉曲张患者452例,其中临床随访资料完整337例.左侧285例,双侧52例;曲张Ⅱ度269例,Ⅲ度68例;患侧阴囊坠痛不适238例;婚后不育265例,病程1～13年.其中行腹腔镜下保留精索动脉及淋巴组织的高选择性精索静脉高位结扎术（A组）249例（合并不育197例）,行腹腔镜下精索血管集柬结扎术（B组）88例（合并不育68例）.统计学分析2组手术时间、术后鞘膜积液、睾丸萎缩、复发等及精液改善和生育情况.结果 337例手术均成功,术后随访2年.2组手术时间分别为（38.0±10.9）min、（19.0±7.5）min,鞘膜积液发生率分别为0.4%（1/249）、11.3%（10/88）,睾丸萎缩发生率分别为0.0%（0/249）、3.4%（3/88）,术后3个月精液质量提高率分别为77.1%（192/249）、62.5%（55/88）,术后2年配偶自然怀孕率分别为56.8%（112/197）、39.7%（27/68）,以上指标2组间比较差异均有统计学意义（P〈0.05）.2组复发率分别为5.6%（14/249）、4.5%（4/88）,组间比较差异无统计学意义（P〉0.05）.结论 腹腔镜下高选择性精索静脉高位结扎术术后并发症发生率低,精液质量提高率和术后2年配偶自然怀孕率高,有推广价值.
Objective To discuss the treatment choices of varicocele by laparoscopic. Methods Retrospective analysis clinical datas of 337 patients with primary varicocele above grade Ⅱ.All of them were treated by operation and followed-up,238 cases had scrotum pain.265 cases were infertility after married.History of diseases was between 1-13 years.249（197 patients with infertility）were treated with laparoscopic high selective ligation of spermatic veins,as Group A.88（68 patiets with infertility）were treated with laparoscopic cluster ligation,as Group B.The clinical data were compared. Results Three hundreds and thirty-seven cases were followed-up 2 years after operation.The operative times of two groups were（38.04±10.9）min、（19.04±7.5）min,the incidences of hydrocelewere 0.4%（1/249）,11.3%（10/88）;theincidences oftesticular atrophywere 0%（0/249）,3.4%（3/88）;the improving rates of semen quality in 3 months were 77.1%（192/249）,62.5%（55/88）;the spontaneous pregnant rates of his spouses in 2 years were 56.8%（112/197）,39.7%（27/68）.There were significant differences among the 2 groups（P〈0.05）.The recurrence rates were 5.6%（14/249）,4.5%（4/88）,there was no significant difference among the 2 groups（P〉0.05）. Conclusion Laparoscopic high selective ligation of spermatic veins in this study had less complications,higher improving rates of semen quality and pregnant rates.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2010年第7期493-495,共3页
Chinese Journal of Urology
作者简介
通信作者：井汉国，Email：jhg311@yahoo．com.cn
