腹腔镜手术精索静脉曲张治疗后的生育能力恢复研究

Rehabilitation Study of Varicocele after Laparoscopic Surgery for Varicocele

目的研究腹腔镜手术精索静脉曲张治疗后的生育能力恢复。方法随机选取2014年8月—2016年8月淄博市计划生育技术指导中心男性科收治的精索静脉曲张患者60例,采用SPSS21.0将入组患者按先后序列号(1~60)随机分为2组:一组腹腔镜精索静脉高位结扎术治疗组(腹腔镜手术组,30例),一组开腹腹膜后精索静脉高位结扎术治疗组(开腹手术组,30例),统计分析两组患者的精子密度、活动率、畸形率、手术时间、术后肠功能恢复时间、住院时间、术后并发症发生情况。结果腹腔镜手术组患者的精子密度、活动率(26.4±3.6)×106/mL、(55.7±3.3)%均显著高于开腹手术组(18.8±2.7)×106/mL、(32.0±4.2)%(t=6.965,4.541,P<0.05),畸形率(64.1±4.3)%显著低于开腹手术组(80.2±6.1)%(t=4.365,P<0.05)。腹腔镜手术组患者的双侧手术时间、住院时间(40.4±10.1)min、(3.1±1.0)d均显著短于开腹手术组(63.3±15.2)min、(7.2±2.4)d(t=4.303,4.182,P<0.05),但两组患者的单侧手术时间、术后肠功能恢复时间(36.6±8.8)min、(18.5±4.6)hvs(39.4±10.6)min、(15.1±3.5)h之间的差异无统计学意义(t=1.886,1.638,P>0.05)。腹腔镜手术组、开腹手术组患者的术后并发症发生,10.0%(3/30)、13.3%(4/30)之间的差异无统计学意义(χ^2=1.32,P>0.05)。结论腹腔镜手术较开腹手术精索静脉曲张治疗后更能有效恢复患者的生育能力。

Objective To study the recovery of fertility after varicocele treatment in laparoscopic surgery. Methods A total of 60 patients with varicocele admitted to the male family of Zibo City Family Planning Technical Guidance Center from August 2014 to August 2016 were randomly selected. The patients were randomly assigned to the serial number (1-60) by SPSS21.0 and were divided into two groups of laparoscopic varicocele ligation group(30 cases in laparoscopic surgery group), one group of open laparoscopic varicocele ligation group(open surgery group, 30 cases). The sperm density, activity rate, deformity rate, operation time, postoperative intestinal function recovery time, hospitalization time, and postoperative complications were analyzed statistically. Results The sperm density and activity rate of patients in the laparoscopic surgery group (26.4±3.6)×106/mL and (55.7±3.3)% were significantly higher than those in the open surgery group (18.8±2.7)×106/mL,(32.0±4.2)%(t=6.965, 4.541, P<0.05), the deformity rate (64.1±4.3)% was significantly lower than that of the open surgery group (80.2±6.1)%(t=4.365, P<0.05). The bilateral operation time and hospitalization time (40.4±10.1) min and (3.1±1.0)d in the laparoscopic surgery group were significantly shorter than those in the open surgery group (63.3±15.2)min,(7.2±2.4) d (t= 4.303, 4.182, P<0.05), but the unilateral operation time and postoperative intestinal function recovery time (36.6±8.8) min,(18.5±4.6)h vs (39.4±10.6)min,(15.1±3.5)h, was not significant (t=1.886, 1.638, P>0.05). Postoperative complications occurred in the laparoscopic surgery group and the open surgery group of 10.0%(3/30) and 13.3%(4/30) was not significant (χ^2=1.32, P>0.05). Conclusion Laparoscopic surgery can effectively restore the fertility of patients after laparoscopic varicocele treatment.