高频彩超在腹腔镜下不同术式治疗精索静脉曲张的疗效对比观察

The evalation of color Doppler ultrasound in spermatic cord vein varicocele trealment by two surgical precedures

目的探讨高频彩超观察腹腔镜下行精索血管集束状结扎术与单纯精索内静脉结扎术治疗精索静脉曲张的疗效。方法 90例精索静脉曲张患者随机分成两组,A组48例,行腹腔镜下精索血管集束状结扎术;B组42例,行单纯精索内静脉结扎术,对两组患者手术前后的睾丸体积、睾丸血供情况、静脉血管的直径等术后情况进行回顾分析。结果两组病例治愈率差异有显著性(P<0.05);术后患侧睾丸的血流供应、睾丸体积无减小(P>0.05)。手术后静脉最大直径两组间差异均有显著性意义(P<0.05),精索血管集束状结扎术与单纯精索内静脉结扎术有显著性意义。结论彩超能实时跟踪观察两种手术方法的术后改变。腹腔镜精索血管集束状结扎术与单纯精索内静脉结扎术治疗精索静脉曲张均安全、疗效可靠,但前者更具有术后并发症少,手术效果更好等优点。

Objective To investigate efficacy of varicocele treatment between laparoscopic cluster ligation of spermatic cord vessels and simple ligation of internal spermatic cord veins with high frequency color Doppler ultrasound.Methods90 patients with varicocele were randomly divided into two groups：48cases in group A,performed laparoscopic cluster ligation of spermatic cord vessels;42cases in group B,performed simple ligation of internal spermatic cord veins.We analyed preoperatively and postoperatively about the testis volume,testicular blood supply,diameter of veins and clinical manifestations of post-operation.Results The testis volume and the testicular blood supply of the affected testis had no degradation（P〉0.05）;There was a significant difference on maximum diameter of veins between the preoperation group and post-operation group（P〈0.05）.There were significant differences between laparoscopic cluster ligation of spermatic cord vessels and simple ligation of internal spermatic cord veins in the post-operation complications and recurrence.Conclusion The color Doppler ultrasound can offer real-time tracking appears on the treatment efficacy of the two surgical precedures.The two surgical precedures,laparoscopic cluster ligation of spermatic cord vessels and simple ligation of internal spermatic cord veins,were both have reliable efficacy and safety,but the former has less complications and better surgery advantages.