显微镜下精索静脉结扎术治疗左侧精索静脉曲张效果分析

Efficacy of Microsurgical Varicocele Ligation in the Treatment of Left Varicocele

目的:研究显微镜下精索静脉曲张结扎术对精索静脉曲张患者诊疗效果。方法:对2018年月-2020年1月因精索静脉曲张在广东医科大学附属医院泌尿外科行显微镜下精索静脉曲张结扎术的198例患者进行了追踪随访,评估比较手术前后血清睾酮、精子DNA碎片化指数、正常形态精子、精子浓度、前向运动精子,以及手术时间、住院时间、术后并发症和术后复发情况。结果:198例患者手术均获得成功,术后3个月41例电话随访,157例门诊复诊随访,术后6个月74例电话随访,124例门诊复诊随访。手术时间(75.00±7.65)min;术后住院时间(2.38±0.56)d。术后无睾丸萎缩,1例鞘膜积液,3例伤口感染,5例阴囊水肿,3例复发。术后3、6个月正常形态精子、精子浓度、前向运动精子均较术前改善,差异有统计学意义(P<0.05)。术后3、6个月睾酮均较术前明显改善,差异有统计学意义(P<0.05),术后3、6个月精子DNA碎片化指数均较术前明显改善,差异有统计学意义(P<0.05)。结论:显微镜下精索静脉曲张结扎术治疗左侧精索静脉曲张安全,且疗效显著。

Objective:To study the efficacy of microsurgical varicocele ligation on the diagnosis and treatment of varicocele patients.Method:A total of 198 patients who underwent microsurgical varicocele ligation in Urology Department of Affiliated Hospital of Guangdong Medical University from January 2018 to January 2020,were followed up.Serum testosterone,sperm DNA fragmentation index,normal sperm morphology,sperm concentration,forward motile sperm rate before and after operation,operation time,length of stay,postoperative complications and postoperative recurrence were evaluated and compared.Result:All of the 198 operations were successful.41 patients were followed up by telephone 3 months after operation,157 patients were followed up and reexamined by outpatient service;74 patients were followed up by telephone 6 months after operation,and 124 patients were followed up and reexamined by outpatient service.The operation time ranged from (75.00±7.65) min.The average postoperative length of stay was (2.38±0.56) d.After operation,there was no cases with testicular atrophy,1 case with hydrocele,3 cases with wound infection,5 cases with scrotal edema and 3 cases with recurrence.Compared with those before operation,the normal sperm morphology,sperm concentration and forward motile sperm were improved 3 months and 6 months after operation,and the differences were statistically significant (P<0.05).Testosterone were significantly improved 3 months and 6 months after operation,and the differences were statistically significant (P<0.05).Sperm DNA fragmentation index were significantly improved in 3 months and 6 months after operation,and the differences were statistically significant (P<0.05).Conclusion:Microscopic varicocele ligation is a safe and effective method to treat left varicocele.