曲张精索静脉显微剥脱术与腹腔镜下精索静脉高位结扎术的临床对比分析

Clinical Comparative Analysis of Varicose Veins and Micro-exfoliation and Laparoscopic High Ligation of Spermatic Vein

目的分析比较曲张精索静脉显微剥脱术与腹腔镜下精索静脉高位结扎术的临床效果。方法该次研究抽取该院2017年1月—2018年1月期间收治的100例精索静脉曲张患者作为研究对象。并根据患者用随机抽取法将其分为两个组别,显微治疗组和腹腔镜治疗组,该次研究已征得患者本人及其家属同意。两组患者分别采用曲张精索静脉显微剥脱术和腹腔镜下精索静脉高位结扎术进行治疗。治疗后对两组患者静脉曲张复发率、配偶妊娠率、精液浓度的改善程度、睾丸水肿发生率等情况进行比对。结果通过对比,腹腔镜治疗组患者的精液浓度改善率为76%,显微治疗组的精液浓度改善率为70%,差异无统计学意义(P>0.05),复发率来看,显微治疗组复发率2%,腹腔镜治疗组复发率10%;差异有统计学意义(χ^2=8.43,P<0.05),配偶妊娠来看,显微治疗组妊娠率30%,腹腔镜治疗组妊娠率20%;差异无统计学意义(χ^2=8.53,P>0.05)。睾丸疼痛率来看,显微治疗组复发生率6%,腹腔镜治疗组发生率8%,差异无统计学意义(χ^2=8.22,P>0.05)。结论曲张精索静脉显微剥脱术在诸多并发症的控制以及复发率的控制都优于腹腔镜下精索静脉高位结扎术。

Objective To analyze the clinical effect of varicose vein venous microsurgery and laparoscopic high ligation of varicocele.Methods This study extracted 100 cases of our hospital from January 2017 to January 2018.Patients with varicose veins were studied.According to the patient's random selection method,they were divided into two groups,microscopic treatment group and laparoscopic treatment group.The study has obtained the consent of the patient and his family.The patients in the two groups were treated with varicose veins and micro-exfoliation and laparoscopic high ligation of the spermatic vein.After treatment,the varicose recurrence rate,the maternal pregnancy rate,the improvement of semen concentration,and the incidence of testicular edema were compared between the two groups.Results By contrast,the improvement rate of semen concentration in the laparoscopic treatment group was 76%,and the improvement rate of semen concentration in the microsurgery group was 70%:the difference was not statistically significant(P>0.05).The recurrence rate was 2% in the micro-treatment group and 10% in the laparoscopic treatment group,the difference was statistically significant(χ^2=8.43,P<0.05),the pregnancy rate of the micro-treatment group was 30%,and the pregnancy rate of the laparoscopic treatment group was statistically significant(χ^2=8.43,P<0.05),the pregnancy rate of laparoscopic treatment group was 20%;the difference was not statistically significant(χ^2=8.53,P>0.05).In terms of testicular pain rate,the recurrence rate was 6%in the microsurgery group and 8%in the laparoscopic treatment group,which was not statistically significant(χ^2=8.22,P>0.05).Conclusion Microdissection of varicocele is superior to laparoscopic high ligation of spermatic vein in controlling many complications and recurrence rate.