196例精索静脉曲张患者的婚后生育情况追踪

Fertility conditon follow-up of 196 patients with varicocele after marriage

目的追踪精索静脉曲张(VC)患者婚后不育情况,比较其治疗前后的精液质量,进一步了解VC对生育的影响。方法左侧或双侧腹膜后精索静脉高位结扎术,术后3个月进行精液质量分析。结果双侧VC不育率较左侧VC高(26.19%比13.39%);本组病例手术前、后对比:术后精子活动级数a级有明显增加(t=8.768,p=0.000);精子的正常形态比例也有所升高(t=3.425,p=0.003);平均精子曲线运动速度明显加快(t=3.425,p=0.003);精子密度显著增多(t=2.885,p=0.009)。结论①双侧VC较左侧VC患者更易不育;②精索内静脉高位结扎术后,精液质量明显提高;③双侧Ⅱ～Ⅲ度VC患者,宜早期行手术治疗,以防VC对双侧睾丸生精功能的进一步损害。

Objectives To follow up the sterility condition of patients with varicocele after marriage. To compare the quantity and quality of the semen before and after treatment and the varicocele effects on fertility. Methods High ligation of retroperitoneal spermatic vein on left side or both sides were performed. The quality analysis of the semen was made 3 months after operation. Result The sterility rate of both side - varicocele was higher than that of only left side varicocele （26.19% ： 13.39% ）. Comparison before and after operation was performed on these patient - groups. The motility grade - a of the semen after operation was markedly increased （ t = 8. 768, p = 0. 000）. The ratio of the normal figure of the semen was also elevated （ t = 3. 425, p = 0.003 ） ; Average semen curve movement velocity was markedly increased（ t = 3. 425, p =0. 003 ） ;semen＇s density was markedly increased （ t = 2. 885, p = 0. 009）. Conclusions ①The sterility of both - side varicoceles is more common than of leftside alone; ②After high ligation of internal spermatic vein, the quantity and quality of the semen are markedly increased ; ③It is very necessary to carry out the early operation on patients with varicoceles of both sides of Ⅱ - Ⅲgrade to prevent the further damage to the spermatogenic function of both testicles.