征兵体检中精索静脉曲张手术方式比较

Comparison of surgical methods for varicocele in conscription physical examination

目的目前征兵体检中中重度精索静脉曲张经手术矫正后可继续参军,比较传统精索静脉高位结扎术与外环下精索静脉显微结扎术的临床疗效及安全性。方法回顾性分析2015年6月~2018年9月因征兵体检来手术的中重度精索静脉曲张患者100例,采用传统经腹股沟精索静脉高位结扎术的40例患者为A组,采用外环下精索静脉显微结扎术的60例患者为B组;比较两组的手术时间、术中出血量、术后住院时间、术后并发症发生情况及术后复发率。结果(1)A组术后住院时间、手术时间均明显长于B组,术中出血量明显多于B组(P<0.05)。(2)A组并发症发生率为25.00%,B组并发症发生率为6.67%,A组并发症发生率明显高于B组(P<0.05)。(3)术后随访1年,A组术后复发5例,复发率为12.50%;B组术后复发1例,复发率为1.67%;A组术后复发率明显高于B组(P<0.05)。结论相比于传统经腹股沟精索静脉高位结扎术,外环下精索静脉显微结扎术对患者创伤更小,术后恢复快,安全性高,且降低了复发率,更适合征兵体检中中重度精索静脉曲张患者。

Objective At present,candidates with moderate to severe varicocele(VC)in the conscription physical examination could continue to join the army after surgical correction.To compare the clinical efficacy and safety of traditional high ligation of spermatic vein and microsurgical subinguinal varicoceletomy(MSV).Methods A retrospective analysis was carried out on 100 cases with moderate and severe VC who came to our hospital for operations from June 2015 to September 2018.Candidates who underwent traditional transinguinal high ligation of spermatic vein were taken as group A(n=40),while those who underwent MSV were taken as group B(n=60).The operation time,intraoperative blood loss,postoperative hospitalization time,postoperative complications and postoperative relapse rate of the two groups were observed and compared.Results(1)The postoperative hospitalization time and operation time of group A was significantly longer than that of group B,and the intraoperative blood loss was significantly more than that of group B(P<0.05).(2)The incidence of complications was 25.00%in group A and 6.67%in group B,the incidence of complications in group A was significantly higher than that in group B(P<0.05).(3)After 1-year follow-up,there were 5 relapsed cases in group A,with a relapse rate of 12.50%.1 case relapsed in group B,with a relapse rate of 1.67%.The relapse rate in group A was significantly higher than that in group B(P<0.05).Conclusion Compared with the traditional transinguinal high ligation of spermatic vein,the MSV has less trauma to the patient,with faster postoperative recovery,high safety,reduced relapse rate,which is more suitable for patients with moderate to severe varicocele in conscription physical examination.