不同术式治疗精索静脉曲张的疗效比较

Comparison of high ligatton by different operation for the treatment of varicocele

目的比较腹腔镜和开放手术集束或单纯结扎精索内静脉治疗原发性精索静脉曲张的疗效。方法将2007年6月-2011年10月济宁市第一人民医院泌尿外科收治的120例精索静脉曲张患者分为4组，每组30例，观察并比较4组患者的疗效。结果4组手术均获成功，无并发症发生。腹腔镜组平均住院时间显著短于开放手术组（P〈0．05）。4组术后6个月精液质量明显改善，差异有统计学意义（P〈0．05）：组间比较差异无明显统计学意义（P〉0．05）。随访0．5～1年，失防9例，随访率为92．5％，患者均无睾丸萎缩等远期并发症发生。结论腹腔镜精索内血管集束高位结扎术治疗精索静脉曲张疗效确切，为治疗精索静脉曲张提供了一种可供选择的方法。

Objective To compare the effects of laparoscopy and open surgery of ligation of spermatic vessel cluster or internal spermatic vein for the treatment of varicocele. Methods By using randomized controlled trial, 120 cases with varicocele who stayed and were treated in our hospital were divided into 4 groups （30 cases every group） from Jun. 2007 to Oct. 2011. The efficacy of 4 groups was observed and compared. Results Four operations were performed successfully. Laparoscopy approached less than open surgery in terms of the days of stay in hospital（ P 〈 0.05 ）. The quality of semen in four groups was all increased by comparing spermatozoa density, motility rate before and after operation（ P 〈 0.05 ）, but no difference was found among four groups（ P 〉 0.05 ）. In 0.5 - 1 year follow-up, follow-up rate was 92.5 %, without atrophy of testes. Conclusion The operation of laparoscopic spermatic vessel cluster ligation in patients with varicoceh has the advantage of confirmed effect, which is an alternative operative method of treatment for patients with varicocele.