腹腔镜下精索静脉高位结扎治疗精索静脉曲张患者的疗效

The Effect of Laparoscopic High Ligation of the Spermatic Vein in the Treatment of Varicocele

目的探讨腹腔镜下精索静脉高位结扎治疗精索静脉曲张患者的疗效。方法选择2017年6月~2019年6月我院收治的84例精索静脉曲张患者,按照随机数字表法分为观察组和对照组,每组42例。对照组给予开放式精索静脉高位结扎术,观察组给予腹腔镜下精索静脉高位结扎术,比较两组临床指标(手术时间、术中出血量、住院时间及术后疼痛评分)、精子质量及并发症发生情况。结果观察组手术时间、术中出血量、住院时间、术后疼痛评分优于对照组,差异有统计学意义(P<0.05)。观察组精子浓度、精子活力高于对照组[(54.29±6.85)×10^6/ml vs(43.57±5.34)×10^6/ml]、[(73.68±8.41)%vs(65.15±7.02)%],精子畸形率低于对照组[(13.44±2.18)%vs(17.79±2.93)%],差异有统计学意义(P<0.05)。观察组并发症发生率为4.76%,低于对照组的19.05%,差异有统计学意义(P<0.05)。结论腹腔镜下精索静脉高位结扎治疗精索静脉曲张患者临床疗效确切,可减少术中出血量、有效缩短手术时间,减轻手术疼痛,且可改善精子质量,安全性高。

Objective To investigate the effect of laparoscopic high ligation of the spermatic vein in the treatment of varicocele patients.Methods A total of 84 varicocele patients admitted to our hospital from June 2017 to June 2019 were selected and divided into observation group and control group according to the random number table method,with 42 cases in each group.The control group was given open high ligation of the spermatic vein,and the observation group was given laparoscopic high ligation of the spermatic vein.The clinical indicators(operation time,intraoperative blood loss,hospital stay and postoperative pain score)and sperm quality were compared between the two groups And complications.Results The operation time,intraoperative blood loss,hospitalization time,and postoperative pain score of the observation group were better than those of the control group,the difference was statistically significant(P<0.05).The sperm concentration and sperm motility of the observation group were higher than those of the control group[(54.29±6.85)×10^6/ml vs(43.57±5.34)×10^6/ml],[(73.68±8.41)%vs(65.15±7.02)%],sperm deformity rate was lower than that of the control group[(13.44±2.18)%vs(17.79±2.93)%],the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 4.76%,it was lower than 19.05%of the control group,the difference was statistically significant(P<0.05).Conclusion Laparoscopic high ligation of the spermatic vein had a definite clinical effect in the treatment of varicocele patients.It could reduce intraoperative blood loss,effectively shorten operation time,reduce surgical pain,and improve sperm quality with high safety.