鞘膜切除术与鞘膜翻转术治疗睾丸鞘膜积液的临床效果比较

Comparison of the effects of sheath excision and sheath turnover in the treatment of testicular hydrocele

目的比较鞘膜切除术与鞘膜翻转术治疗睾丸鞘膜积液的临床效果。方法选取金华市第五医院2016年1月至2018年12月收治的睾丸鞘膜积液患者84例,按照随机数字表法并根据手术方式不同分为切除组(42例,行鞘膜切除术)和翻转组(42例,行鞘膜翻转术),比较两组的治疗效果、并发症等情况。结果两组手术时间[(15.06±1.84)min比(17.91±2.13)min]、术中出血量[(5.53±1.22)mL比(6.72±1.51)mL]及阴囊肿胀大小[(1.67±0.42)cm比(2.79±0.55)cm]差异均有统计学意义(t=6.562、3.973、10.489,均P<0.05);两组住院时间及术后体温差异均无统计学意义(均P>0.05);切除组愈显率90.48%(38/42),显著高于翻转组的69.05%(29/42)(χ^2=4.720,P<0.05);随访6个月,两组均未见并发症及复发病例。结论鞘膜切除术与鞘膜翻转术均是睾丸鞘膜积液的常用术式,但前者操作时间短,术中出血少、术后肿胀反应轻,更值得推荐。

Objective To compare the clinical effects of sheath excision and sheath turnover in the treatment of testicular hydrocele.Methods From January 2016 to December 2018,84 patients with testicular hydrocele admitted to the Fifth Hospital of Jinhua were divided into resection group(42 cases received resection)and inversion group(42 cases received inversion operation).The therapeutic effect and complications of the two groups were compared.Results The operation time[(15.06±1.84)min vs.(17.91±2.13)min],intraoperative bleeding[(5.53±1.22)mL vs.(6.72±1.51)mL]and the size of scrotal cyst swelling[(1.67±0.42)cm vs.(2.79±0.55)cm]between the two groups had statistically significant differences(t=6.562,3.973,10.489,all P<0.05).There were no statistically significant differences in hospitalization time and body temperature between the two groups(all P>0.05).The cured and markedly effective rate of the resection group was 90.48%(38/42),which was higher than 69.05%(29/42)of the inversion group(χ^2=4.720,P<0.05).No complications or recurrence were found in the two groups after 6 months of follow-up.Conclusion Excision and sheath reversal are common methods for the treatment of testicular hydrocele,but the former is recommended for its short operation time,less bleeding during operation and less swelling reaction after operation.