腹腔镜精索静脉高位结扎术对睾丸动脉血流参数的影响

Effect of laparoscopic varicocelectomy on testicular arterial blood flow

目的应用彩色多普勒血流成像(CDFI)技术观察腹腔镜左侧精索静脉高位结扎术对该侧睾丸内动脉(ITA)和包膜动脉(CA)血流参数的影响。方法选择29例左侧精索静脉曲张并行同侧腹腔镜精索静脉高位结扎术的患者,使用CDFI技术在术前1周和术后3、6个月检测双侧CA和ITA向心支的收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)及搏动指数(PI)。结果手术前后比较,患者左侧ITA和CA的RI、PI及PSV值均降低,差异有统计学意义(P﹤0.05),其中RI、PI的改变较PSV降低更明显(P﹤0.01)。术后6个月各指标较术后3个月下降更明显,差异有统计学意义(P﹤0.05),但EDV无明显变化,差异无统计学意义。患者右侧ITA和CA的各血流参数值手术前后比较差异均无统计学意义。结论腹腔镜精索静脉高位结扎术后患者患侧ITA和CA的血流动力学参数均有显著改善;ITA和CA的RI、PI值可作为检测腹腔镜精索静脉结扎术后患者手术效果的一项重要指标。

Objective To investigate the effects of unilateral laparoscopic varicocelectomy on blood flow parameters of intratesticular artery （ITA） and capsular artery （CA） using color Doppler flow imaging （CDFI）.Methods A total of 29 patients diagnosed asleft varicocele clinically underwent laparoscopic varicocelectomies. CDFI was then used to measure the peak systolic velocity （PSV） ,end diastolic velocity （EDV）,resistive index （RI） and pulsatility index（PI） of bilateral ITA and CA at one week before surgery and 3,6 months postoperation. Results The values of RI, PI and PSV in the left ITA and CA decreased after surgery （P 〈 0.05 ）. And the change of RI and PI was more remarkable than that of PSV （P 〈 0.01 ）.The change at 6 months was more significant than that at 3 months after operation.Whereas no significant difference was found in EDV.No differences were detected in the fight ITA and CA between the preoperative and postoperative blood flow parameters.Conclusion The ipsilateral intratesticular hemodynamics was greatly improved after unilateral laparoscopic varicocelectomy.The values of RI and PI of ITA and CA can be used to assess the efficacy of surgery.