放大镜辅助下精索静脉结扎术与腹腔镜下精索内静脉高位结扎术治疗精索静脉曲张的疗效比较

Comparison of efficacy between magnifier-assisted varicocele ligation and laparoscopic varicocele high ligation for treatment of varicocele

目的探讨放大镜辅助下精索静脉结扎术与腹腔镜下精索内静脉高位结扎术治疗精索静脉曲张的疗效。方法纳入精索静脉曲张伴精子质量异常的患者81例,随机分为研究组(41例)和对照组(40例)。研究组行放大镜辅助下精索静脉结扎术,对照组行腹腔镜精索内静脉高位结扎术。记录两组手术时间、术后住院时间;观察术后1年内患者阴囊水肿、附睾炎及睾丸鞘膜积液的发生率及术后复发率;比较术后3、6、9、12个月精液常规检测结果。结果研究组手术时间长于对照组,差异有统计学意义(P<0.05)。两组术后住院时间比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。研究组术后无复发,对照组术后复发8例(20.0%),两组比较,差异有统计学意义(P<0.05)。两组患者术后不同时期精子质量均较术前明显改善,且精子质量随时间增加而不断提高,差异有统计学意义(P<0.05)。同时期组间精子质量比较,差异无统计学意义(P>0.05)。结论放大镜辅助下精索静脉结扎术治疗精索静脉曲张效果优于腹腔镜手术,且具有更低的复发率。

Objective To explore the efficacy of magnifier-assisted varicocele ligation and laparoscopic varicocele high ligation for treatment of varicocele. Methods Eighty-one patients with varicocele complicwith abnormal sperrm quality were enrolled and were divided into study group （ n = 41 ） and control group （n = 40）. The experimental group was treated with magnifier-assisted varicocele ligation, and the control group with laparoscopic varicocele high ligation. The operation duration and the postoperative hospital stay of both groups were recorded. The incidence of scrotum edema, epididymitis and hydrocele tes tis, and the recrudescence rate within 1 year after operation were observed. The results of sperm routine test at 3 months, 6 months, 9 months and 12 months were compared. Results The operation duration of the study group was longer than that of the control group （P 〈 0 . 0 5 ） . There were no significant differences in the postoperative hospital stay and the incidence of complications between the two groups（P 〉0. 05） . The recrudescence rate ofthe study group was significantly less than that of the control group[0 vs 20. 0% （840） , groups, the sperm quality at different time points after operation were obviously improved compared to thequality before operation, and were improved by the t ime（P 〈0. 05） . There was no statistical difference in sperm quality between the two groups at each time point （ P 〉0. 05）. Conclusion Magnifier-assisted varicocele ligation can achieve better efficacy and lower recrudescence rate for varicocele compared to laparoscopic varcocele high ligation.