显微镜下精索静脉结扎改善性激素水平 睾丸血流动力学及精液质量的研究

Study on microscopic spermatic vein ligation in improving sex hormone level, testicular hemodynamics and semen quality

目的探讨显微镜下精索静脉结扎改善性激素水平、睾丸血流动力学及精液质量的效果。方法选取2018年4月—2019年5月我院收治的精索静脉曲张患者70例,随机分为对照组和观察组各35例。对照组行传统腹股沟途径精索静脉结扎术治疗,试验组行显微镜下精索静脉结扎治疗,对比2组手术时间、住院时间、睾丸血流动力学、性激素水平以及精液质量和并发症发生情况。结果观察组住院时间短于对照组,向心支收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)和搏动指数(PI)优于对照组,精子密度、精子活力、睾酮(T)水平高于对照组,黄体生成素(LH)水平低于对照组,差异均有统计学意义(P<0.05)。观察组手术时间略高于对照组,且并发症略低于对照组,但差异无统计学意义(P>0.05)。结论显微镜下精索静脉结扎术能够改善精索静脉曲张患者性激素水平以及睾丸血流动力学,提高精液质量,且并发症少,安全性高。

Objective To investigate the effect of microscopic spermatic vein ligation in improving sex hormone level,testicular hemodynamics and semen quality.Methods 70 patients with varicocele who admitted in the hospital from April 2018 to May 2019 were selected,and they were divided into control group and observation group according to random number generated by computer program,and experimental group was treated with microscopic spermatic vein ligation.The operation time,hospital stays,testicular hemodynamics,sex hormone level,semen quality and complications were compared between two groups.Results The hospital stays in observation group were shorter than those in control group,the peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI)and pulsatility index(PI)in observation group were better than those in control group,the sperm density,sperm motility and testosterone(T)in observation group were higher than those in control group,and the luteinizing hormone(LH)in observation group was lower than that in control group(P<0.05);The operation time of observation group was slightly higher than that of control group,and the complications in observation group were slightly lower than those in control group,but the difference was not statistically significant(P>0.05).Conclusion Microscopic spermatic vein ligation can improve the sex hormone level and testicular hemodynamics,increase semen quality,and have less complications and high safety.