分析显微外科手术与腹腔镜手术治疗精索静脉曲张的效果

Analysis of the effect of microsurgery and laparoscopic surgery in the treatment of varicocele

目的 分析显微外科手术与腹腔镜手术治疗精索静脉曲张(VC)的临床效果。方法 96例精索静脉曲张患者作为试验对象,采用双盲随机抽样法分为对照组和试验组,每组48例。试验组给予显微外科手术治疗,对照组给予腹腔镜手术治疗。对比两组患者治疗效果、并发症发生情况、手术时间、排气时间、住院天数、住院费用及治疗前后精液质量。结果 对照组总有效率为85.42%,试验组总有效率为97.92%;试验组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组精子密度、精子数量、精子活率及(a+b)级精子数比较差异均无统计学意义(P>0.05);治疗后,试验组精子密度、精子数量、精子活率及(a+b)级精子数均优于对照组,差异有统计学意义(P<0.05)。试验组并发症发生率为16.67%,低于对照组的4.17%,差异有统计学意义(P<0.05)。试验组手术时间(42.86±16.36)h、排气时间(23.58±9.85)h、住院天数(6.25±2.42)d均短于对照组的(50.55±20.54)h、(39.78±11.47)h、(7.69±3.47)d,住院费用(3145.22±504.78)元少于对照组的(3758.44±845.26)元,差异有统计学意义(P<0.05)。结论 精索静脉曲张患者给予显微外科手术治疗具有显著优势,可显著提升患者的治疗效果,同时可积极改善精液质量与精索静脉曲张手术指标,减少并发症,值得临床推广与采纳。

Objective To analyze the clinical effect of microsurgery and laparoscopic surgery in the treatment of varicocele(VC).Methods A total of 96 varicocele patients as study subjects were divided into control group and experimental group by random double-blind method,with 48 cases in each group.The experimental group was treated by microsurgery,and the control group was treated by laparoscopic surgery.The therapeutic effect,occurrence of complications,operation time,exhaust time,hospitalization time,hospitalization expenses and semen quality before and after treatment was compared between the two groups.Results The total effective rate was 85.42% in the control group,which was 97.92% in the experimental group.The total effective rate in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in sperm density,sperm number,sperm viability and(a+b)grade sperm number between the two groups(P>0.05).After treatment,the sperm density,sperm number,sperm viability and(a+b)grade sperm number in the experimental group was better than those in the control group,and their difference was statistically significant(P<0.05).The incidence of complications was 16.67% in the experimental group,which was lower than 4.17% in the control group,and the difference was statistically significant(P<0.05).The operation time,exhaust time and hospitalization time were(42.86±16.36)h,(23.58±9.85)h and(6.25±2.42)d in the experimental group,which was shorter than(50.55±20.54)h,(39.78±11.47)h and(7.69±3.47)d in the control group,and hospitalization expenses(3145.22±504.78)yuan was less than(3758.44±845.26)yuan in the control group.Their difference was statistically significant(P<0.05).Conclusion Microsurgery shows significant advantage for varicocele patients,and it can significantly improve the treatment effect of patients,and can actively improve the quality of semen and varicocele surgery indicators,reduce complications,which is worthy of clinical promotion and adoption.