改良外环下显微镜精索静脉结扎术治疗精索静脉曲张疗效分析

Clinical Effect of Spermatic Vein Ligation on Varicocele under Modified Outer Ring

【目的】探讨改良外环下显微镜精索静脉结扎术治疗精索静脉曲张中的临床效果。【方法】回顾性分析2015年1月至2016年12月本院收治i00例精索静脉曲张患者的临床资料，根据患者的手术方式将其分为显微镜组和传统手术组，每组各50例。比较两组的手术效果、手术并发症发生率以及手术前后精子密度及活力。【结果】显微镜组的手术时间高于传统手术组，住院时间低于传统手术组，VAS评分显著低于传统手术组，差异均具有统计学意义（P〈0．05）。两组患者术后精子密度和活力均显著高于术前，且显微镜组优于传统手术组，差异有统计学意义（P〈0．05）；显微镜组术后并发症发生率明显低于传统手术组（4．0％ vs 32．0％），差异具有统计学意义（X2=12．53，P〈0．05）。【结论】改良外环下显微镜精索静脉结扎术治疗精索静脉曲张疗效显著，能够有效降低术后并发症，改善患者精子密度和活力，同时具有操作便捷的优势，值得在临床中推广应用。

[Objective]To analyze the clinical effect of spermatic vein ligation on varicocele under microscopically modified outer ring. [Methods]The clinical data of 100 patients with varicocele from January 2015 to December 2010 in our hospital were analyzed retrospectively. According to the patients＇ surgical procedure, they were divided into microscope surgery group （modified outer ring） and traditional surgery group （transrectal spermatic cord suture）, with 50 cases in each group. The surgical outcomes, the incidence of complications, the recurrence rate and the semen density and viability were compared between the two groups. [Results]The surgeries in all patients of the two groups were successfully completed. The operation time of the microscope group was significantly longer than that of the traditional group （ P 〈0.05）, but the hospitalization time was significantly lower than that of the traditional operation group （ P〈0.05）. The postoperative VAS score was significantly lower in the microscope group than in the traditional group; the difference was statistically significance （ P〈0.05）. The recurrence rate of the microscope group was significantly lower than that of the conventional operation group （ P〈0.05） . The postoperative sperm and viability of the two groups were statistically higher than those before operation （ P 〈0.05）, and the improvement rate of the microscope group was greater than that of the traditional group （ P 〈0.05）. The incidence of postoperative complications in the microscope group was significantly lower than that in the traditional group（4.0% vs 32.0%, respectively; X2= 12.53, P 〈0.05）.[Conclusion]The modified spermatic vein ligation in the outer ring has good clinical effect in the varieocele, which can effectively reduce the postoperative complications and recurrence rate, improve the semen density and vitality of the patients, and have the advantages of convenient operation. It is worthy of promotion in clinical use.