保留精索内动脉的精索血管集束结扎术对精索静脉曲张患者性功能及精液质量的影响

Influence of spermatic vascular bundle ligation reserving internal spermatic artery on the sexual function and semen quality of varicocele patients

目的:探讨保留精索内动脉的精索血管集束结扎术对精索静脉曲张患者性功能及精液质量的影响。方法:选取2011年8月至2014年8月间接受住院手术治疗的精索静脉曲张患者120例为研究对象,采用随机数字表法分为观察组及对照组各60例。两组患者均接受精索血管集束结扎术,观察组分离精索内动脉并加以保护,对照组连同精索内动脉一同结扎。比较两组患者的精子质量、性功能、SCL-90症状自评、复发率与并发症。结果:精子质量:观察组精子浓度、精子活力明显高于对照组,精子畸形率明显低于对照组(t=7.841~25.261,P<0.05);性功能:观察组性欲、性唤起、性高潮、性满意度等评分明显高于对照组(t=7.527~12.419,P<0.05);心理健康:观察组躯体化因子、强迫症状因子、抑郁因子、精神病性因子评分均明显低于对照组患者(t=16.702~24.349,P<0.05);复发率与并发症:两组术后复发率差异无统计学意义(χ~2=0.208,P>0.05);观察组并发症10.94%明显低于对照组的26.56%(χ~2=5.128,P<0.05)。结论:保留精索内动脉的精索血管集束结扎术,可以有效增强患者的精液质量及性功能,降低术后并发症,提高生活质量。

Objectives： To investigate the influence of spermatic vascular bundle ligation reserving internal spermatic artery on the sexual function and semen quality of varicocele patients. Methods： 120 varicocete patients in our hospital from August 2011 to August 2014 were randomly divided into control group and observation group. All the patients were given spermatic vascular bundle ligation. The spetmatic artery were separated and protected in the observation group while such protection was not carried out in the control group. The sperm quality, sexual function, SCL - 90 symptoms self evaluation, recurrence rate and complications of the two groups were compared. Resuits ： In respect of sperm quality, the sperm concentration and sperm vitality of observation group were significantly higher than those of control group, and the sperm deformity rate were significantly lower than that of the control group （t =7. 841 -25. 261, P 〈0.05）. In respect of sexual function, the sexual desire, sexual arousal, sexual orgasm, sexual satisfaction score in observation group were significantly higher than those of control group （ t = 7. 527 12. 419, P 〈0. 05）. In respect of mental health, the somatization factor, force symptom factor, depression factor and psychotic factor in observation group were significantly lower than those of the control group （ t = 16. 702 - 24. 349, P 〈 0. 05 ）. In terms of recurrence rate and complications, there were no statistically difference in postopera- tive recurrence between the two groups （x^2 = 0. 208, P 〉 0. 05 ） and the incidence of complications in observation group （ 10. 94% ） was significantly than that of the control group （26.56%） （X2 = 5. 128, P 〈 0. 05 ）. Conclu- sion： Spermatic vascular bundle ligation reserving internal spermatic artery can effectively enhance the patient＇s semen quality and sexual function, and reduce the postoperative complications, hereby improving the life quality.