精索静脉曲张程度与术后精子质量改善程度的关系分析

Relationship between the Degree of Varicocele and Postoperative Sperm Quality Improvement

目的研究显微镜下精索静脉结扎手术前患者精索静脉曲张程度与手术后精子质量改善效果之间的关系。方法选择2017年6月—2018年6月辽宁省计划生育科学研究院附属医院收治的术前精索静脉曲张程度分别为Ⅰ度、Ⅱ度、Ⅲ度的患者各19例,均实施精索静脉显微结扎手术,于术后3~6个月复查精子质量,比较手术前后精子核成熟度、精子形态、精子密度、A+B级精子率的变化以及组间变化程度差异。结果Ⅰ度组精子核成熟度、精子形态、精子密度、A+B级精子率在术后相较于术前,差异无统计学意义(P>0.05);Ⅱ度组、Ⅲ度组术后精子核成熟度、精子形态、精子密度、A+B级精子率均有提升,差异有统计学意义(P<0.05)。结论显微镜下精索静脉结扎手术效果会受到患者术前精索静脉曲张程度的影响,Ⅰ度组改善程度并不明显,Ⅱ度组、Ⅲ度组患者精子核成熟度、精子形态、精子密度、A+B级精子率可得到更显著提升。

Objective To study the relationship between the degree of varicocele in patients with spermatic vein ligation before surgery and the improvement of sperm quality after surgery.Methods The patients with preoperative degree,ⅡandⅢvaricocele(n=19 cases in each degree)were selected.All patients underwent spermatic vein microsurgery.The sperm quality was checked after postoperative 3~6 months.Sperm nuclear maturity,sperm morphology,sperm density,A+B sperm rate changes and differences in three degrees between groups were compared.Results In the degreeⅠgroup,sperm nuclear maturity,sperm morphology,sperm density,and A+B sperm rate did not significantly improve after surgery(P>0.05).In degreeⅡandⅢgroups,sperm nuclear maturity,sperm morphology,sperm density,and A+B sperm rate were significantly improved after operation(P<0.05).Conclusion The effect of microsurgical varicocelectomy is affected by the preoperative varicocele degree of the patient.The improvement in degreeⅠgroup was not significant,but in degreeⅡandⅢgroups,the sperm nucleus maturity,sperm morphology,sperm density,and A+B sperm rate were significantly improved.