腹腔镜与显微镜下精索内静脉高位结扎术治疗精索静脉曲张的效果及并发症率的对比

Comparison of the Treatment Effect and Complication Rate of Varicocele by Laparoscopy and Microscope

目的比较精索静脉曲张患者行腹腔镜与显微镜下精索内静脉高位结扎术治疗的效果及并发症情况。方法选取2016年4月19日至2017年3月我院收治的精索静脉曲张患者69例,其中行腹腔镜下手术的34例患者为腹腔镜组,行显微镜下手术的35例患者为显微镜组。观察患者的手术情况、精液质量和并发症情况。结果显微镜组患者的手术时间长于腹腔镜组(P<0.05),住院时间短于腹腔镜组(P<0.05),术后并发症发生率低于腹腔镜组(P<0.05);两组患者出院6个月的精子数量、精子密度和精子活力均明显高于手术前(P<0.05),且显微镜组患者出院6个月的精子数量、精子密度和精子活力均明显高于腹腔镜组患者出院6个月的水平(P<0.05)。结论两种精索内静脉高位结扎术治疗精索静脉曲张对患者精子质量改善情况的差异不明显,但显微镜下手术患者术后恢复快、并发症少,故临床价值较高。

Objective To compare the efficacy and complications of laparoscopic and microscopic high ligation of intravenous veins in patients with varicocele.Methods A total of 69 patients with varicocele admitted to our hospital from April 19,2016 to march,2017 were selected,among whom 34 patients receiving laparoscopic surgery were in the laparoscopic group and 35 patients receiving microscopic surgery were in the microscope group.The operation,semen quality and complications were observed.Results The operation time of the patients in the microscope group was longer than that in the laparoscopic group(P<0.05),the hospitalization time was shorter than that in the laparoscopic group(P<0.05),and the incidence of postoperative complications was lower than that in the laparoscopic group(P<0.05).The sperm quantity,sperm density and sperm motility of patients in both groups were significantly higher at 6 months after discharge than before surgery(P<0.05),and the sperm quantity,sperm density and sperm motility of patients in the microscope group were significantly higher at 6 months after discharge than those in the laparoscopic group(P<0.05).Conclusion The difference between the two types of high ligation of spermatic cord vein in the treatment of varicocele was not significant in the improvement of sperm quality,but the clinical value was higher in the cases of quick recovery and fewer complications after the operation under the microscope.