三种术式治疗精索静脉曲张对男性性功能的影响比较

Impact comparision of three kinds of surgical treatment for varicocele on male sexual function

目的探讨三种术式治疗精索静脉曲张对男性性功能的临床疗效。方法回顾性选取2013年8月—2019年6月九江市第一人民医院收治的140例精索静脉曲张患者作为研究对象,按照不同的手术方法分为开放手术组(37例)、腹腔镜手术组(70例)和显微镜精索静脉结扎术组(33例)。开放手术组采用开放腹膜后精索内静脉高位结扎术方法,腹腔镜手术组采用腹腔镜下精索静脉高位结扎术方法,显微镜手术组采用显微镜精索静脉结扎术方法。比较各组的国际勃起功能指数问卷表(IIEF-5)评分、术后并发症发生情况、外周血激素水平变化情况。结果显微镜手术组的IIEF-5评分高于开放手术组与腹腔镜手术组,差异有统计学意义(P<0.05);显微镜手术组的术后不良反应总发生率低于开放手术组与腹腔镜手术组,差异有统计学意义(P<0.05);显微镜手术组的外周血激素泌乳素、卵泡刺激素及黄体生成素均低于开放手术组与腹腔镜手术组,差异有统计学意义(P<0.05)。结论显微镜精索静脉结扎术对于精索静脉曲张患者具有效果显著,安全性高的优势,值得应用。

Objective To explore and analyze the impact comparision of three surgical treatments for varicocele on male sexual function.Methods A total of 140 patients with varicocele admitted to the First People′s Hospital of Jiujiang City from August 2013 to June 2019 were retrospectively selected as the research objects.They were divided into open operation group(37 cases),laparoscopic operation group(70 cases)and microscopic varicocele ligation group(33 cases)according to different surgical methods.The open operation group was treated with open retroperitoneal high ligation of internal spermatic vein,the laparoscopic operation group was treated with laparoscopic high ligation of spermatic vein,and the microscopic operation group was treated with microscopic ligation of spermatic vein.The international index of erectile function 5(IIEF-5)score,the incidence of postoperative complications and the changes of peripheral blood hormone levels were compared.Results The IIEF-5 score of microsurgery group was higher than that of open operation group and laparoscopic operation group,the difference was statistically significant(P<0.05).The total incidence of postoperative adverse reactions of microsurgery group was lower than that of open operation group and laparoscopic operation group,the difference was statistically significant(P<0.05).The peripheral blood hormone prolactin,follicle stimulating hormone and luteinizing hormone of microsurgery group were significantly lower than those of open operation group and laparoscopic operation group,the differences were statistically significant(P<0.05).Conclusion microscopic varicocele ligation for patients with varicocele has significant effect,high safety advantages,it is worthy of application.