精索血管解剖在经腹股沟下途径显微镜精索静脉结扎术的临床应用

The clinical application of anatomy of spermatic cord vessels in subinguinal microscopic varicocelectomy

目的 探讨经腹股沟下显微镜精索静脉结扎术治疗精索静脉曲张的手术技巧及其疗效分析.方法 总结本院自2014年10月至2016年4月应用经腹股沟下途径显微镜下精索静脉结扎术治疗精索静脉曲张64例患者的临床资料.对术中结扎静脉数量、睾丸动脉数量、手术时间、术后并发症发生率、术后复发率、术后精液质量改善情况进行总结分析.结果 单侧手术时间54-80 min,平均62.16 min.术中均有效保留1-2支睾丸动脉.术中发现精索内静脉数量：（8.67±1.27）条;动脉数量（1.18±0.46）条;术后并发症发生率：阴囊水肿3.12%（2/64）;术后精液质量改善率87.10%（27/31）,临床症状缓解率82.98%（39/47）.结论 经腹股沟下途径显微镜精索静脉结扎术手术并发症少,复发率低,有效保留睾丸动脉,有效改善精液治疗,提高致孕率.掌握精索血管的解剖对手术具有很大帮助.

Objectives To investigate the technique and clinical efficacy of subinguinal microscopic varicocelectomy.Methods The clinical data of 64 cases who underwent subinguinal varicocelectomy from October 2014 to April 2016 in our hospital were summarized.The number of veins and arteries in every spermatic cord,statistic the operation time,incidence of complications,percentage of recrudesce and improvement of semen qaulity were recorded.Results The average operation time of single side was 62.16 min（54-80 min）.The number of veins was （8.67＆#177;1.27）.The number of arteries was （1.18＆#177;0.46）.The incidence of complications：hydroncus of scrotum was 3.12%（2/64）,artrophy of testis was 0%, hydrocele testis was 0%,incidence of recrudesce was 0%, improvement of semen qaulity was 87.10（27/31）.Symtom relaxation was 82.98%（39/47）.Conclusions The subinguinal microscopic varicolcelectomy has less complications,less recrudesce, more protections of the artery of testis,it has good effect on improvement on semen qaulity.Master of the anatomy of spermatic cord vessels is helpful to the operation.