显微精索静脉结扎术治疗男性不育56例报告

Microsurgical varicocelectomy in the treatment of male infertility： a report of 56 cases

目的探讨显微精索静脉结扎术治疗精索静脉曲张不育的临床效果。方法采用显微精索静脉结扎技术治疗56例精索静脉曲张不育患者，观察术前及术后1、3、12个月的精液质量并随访观察1年内配偶的妊娠率。结果56例患者术前精子浓度为（16．1±6．3）×10^6个／ml，术后1、3和12个月的精子浓度分别为（32．3±12．3）×10^6个／ml、（38．3±14．7）×10^6个／ml和（39．9±14．2）×10^6个／ml；术前精子总数为（54．2±18．3）×10^6个，术后1、3和12个月的精子总数分别为（112．5±48．8）×10^6、（125．7±47．7）×10^6和（126．7±49．5）×10^6个；术前前向运动精子总数为（7．3±1．5）×10^6个，术后1、3和12个月的前向运动精子总数分别为（53．8±9．0）×10^6、（66．2±10．2）×10^6和（68．3±11．9）×10。个，术后3项指标均有明显提高，与术前比较，差异均有统计学意义。术后随访1年妊娠率为60．7％。结论显微精索静脉结扎术可显著改善精索静脉曲张不育患者的精液质量，提高奸娠率。

Objective To examine clinical efficacy of microsurgical varicocelectomy in the treatment of male infertihty. Methods Fifty-six infertile patients with varicocele underwent microsurgical varicocelectomy. The quality of their semen were observed at pre-operation, 1 month, 3 months, and 12 months after operation. All the cases were followed up for one year and the pregnant outcomes of their wives were recorded. Results Sperm concentration before operation was （ 16.1 ± 6.3） ×10^6/ml, compared with （32.3 ± 12.3） ×10^6/ml, （38.3 ± 14.7） ×10^6/ml, and （39.9 ± 14.2） ×10^6/ml at 1 month, 3 months, and 12 months after operation, respectively. Sperm count before operation was （54.2±18.3） ×10^6, compared with （112.5±48.8）×10^6, （125.7±47.7） ×10^6, and （126.7±49.5） ×10^6 at 1 month, 3 months, and 12 months, respectively, after operation. Progressive motility of sperm before operation was （7.3±1.5） ×10^6, and was （53.8 ±9.0）×10^6, （66.2± 10.2） ×10^6, and （68.3 ±11.9） ×10^6 at 1 month, 3 months, and 12 months, respectively, after operation. The wives of 34 cases （65 % ） achieved clinical pregnancy. Conclusion Microsurgical varicoeelectomy can improve the semen quality of male infertile patients and increase the pregnancy rate in their wives.