经股静脉和经颈内静脉不同穿刺入路的介入栓塞治疗精索静脉曲张的效果分析

Effect of interventional embolization in the treatment of varicocele via femoral vein and transjugular vein

目的探讨经股静脉和经颈内静脉不同穿刺入路的介入栓塞治疗精索静脉曲张(VC)的效果。方法选取重庆市黔江中心医院于2016年1月至2019年12月收治的VC患者98例,根据治疗方案不同分为对照组(采用经股静脉穿刺入路介入栓塞术治疗)和观察组(经颈内静脉穿刺入路介入栓塞治疗),各49例。比较两组患者手术时间、术后下床活动时间、住院时间及并发症发生率;比较术前及术后3 d两组患者C反应蛋白(CRP)、白细胞介素-6(IL-6);比较术前与术后3个月两组患者精液质量。采用电话或微信平台随访12个月,统计两组患者复发情况和配偶怀孕率。结果观察组患者手术时间、术后下床活动时间、住院时间短于对照组患者,并发症发生率低于对照组患者(P<0.05)。术后3 d,观察组患者CRP和IL-6低于对照组患者(P<0.05);术后3个月,两组患者精液质量、复发率和配偶怀孕率比较,差异无统计学意义(P>0.05)。结论经颈内静脉穿刺入路较经股静脉穿刺入路手术时间短、机体应激反应小、并发症少、住院时间短,但对改善精子质量等疗效相当。

Objective To investigate the effect of interventional embolization of varicocele(VC)through femoral vein and internal jugular vein.Method A total of 98 VC patients were selected from Qianjiang Central Hospital of Chongqing from January 2016 to December 2019.According to different treatment plan,they were divided into control group(interventional embolization via femoral vein puncture)and observation group(interventional embolization via internal jugular vein puncture),49 cases in each group.The operation time,the time of getting out of bed,the time of hospitalization and the incidence of complications were compared between the two groups.The changes of C reactive protein(CRP),interleukin-6(IL-6)and semen quality were recorded before and 3 days after operation.The semen quality was compared between the two groups before and 3 months after operation.The patients were followed up for 12 months by telephone or wechat platform,and the recurrence rate and pregnancy rate of spouses in the two groups were counted.Result Operation time,postoperative movement time out of bed and hospitalization time in the observation group were shorter than those in the control group,and the incidence of complications was lower than that in the control group(P<0.05).Three days after operation,CRP and IL-6 in the observation group were lower than those in the control group(P<0.05).Three months after operation,there was no significant difference in semen quality,recurrence rate and pregnancy rate between the two groups(P>0.05).Conclusion Compared with the femoral vein puncture approach,the internal jugular vein puncture approach was shorter than,the body stress response was small,the complications were less,and the hospitalization time was short,but the long-term effect was equivalent in improving sperm quality.