显微镜下2种手术方法治疗精索静脉曲张的效果

Effect of two microsurgical methods on varicocele

目的:对比分析显微镜下精索静脉高位结扎术(HRV)与显微镜下经外环口精索静脉结扎术(MSV)治疗精索静脉曲张的效果。方法:回顾性分析武警河南总队医院2016年2月至2017年1月收治的精索静脉曲张110例患者的临床资料,分为两组:HRV组(n=55)和MSV组(n=55)。对比两组的手术时间、术中出血量、精子质量等。结果:手术时间MSV组显著长于HRV组(P<0.01);术中出血量和住院时间两组对比无显著性差异(P>0.05);两组术后均未出现明显并发症。术后3个月精子数量、精子成活率、精子浓度MSV组均显著高于HRV组(P<0.01);术后随访1年,精索静脉曲张复发率MSV组显著低于HRV组(1.82%vs 16.36%,P<0.01)。结论:MSV疗效确切,有助于改善精子质量,预防病情复发,值得临床推广。

Objective: To compare and analyze the effect of microscopic high retroperitoneal varicocelectomy ( HRV) and microscopic subinguinal varicocelectomy (MSV) in the treatment of varicocele. Methods: The clinical data of 110 patients with varicocele diagnosed in General Hospital of Henan People's Armed Police Force, from February 2016 to January 2017 were retrospectively collected and divided into two groups: HRV group (n = 55) and MSV group (n = 55). The operation time, blood loss and sperm quality were compared between the two groups. Results: The operation time of MSV group was longer than that of HRV group (P <0.01);there was no significant difference in intraoperative blood loss and hospitalization time between the two groups ( P > 0.05 );there were no obvious complications after operation in both groups. The number of sperm, sperm survival rate and sperm concentration in MSV group were higher than those in HRV group at three months after operation (P <0.01), and the recurrence rate of varicocele in MSV group was lower than that in HRV group at one year follow-up(1. 82% vs 16. 36%,P <0.01). Conclusion: MSV is effective and helpful to improve sperm quality and prevent relapse of the disease. It is worthy of promotion.