经外环下精索静脉结扎术与腹股沟显微精索静脉结扎术对精索静脉曲张患者的精液质量及性激素水平的影响

Effects of Ligation of the Spermatic Vein under the Outer Ring and Microscopic Spermatic Vein Ligation of the Inguinal on the Semen Quality and the Level of Sex Hormones in Patients with Varicocele

目的:对比分析经外环下精索静脉结扎术与腹股沟显微精索静脉结扎术对精索静脉曲张患者的精液质量及性激素水平的影响。方法:113例研究对象,随机分为观察组(n=57)和对照组(n=56),对照组给予腹股沟显微精索静脉结扎术,观察组给予经外环下精索静脉结扎术,对比其精液质量、性激素水平以及并发症发生率。结果:术后半年,两组患者精子密度等相关指标均显著提高,且观察组均较对照组高(P<0.05);两组患者术后血清促卵泡激素(follicle-stimulating hor-mone,FSH)、血清睾酮(testoster-one,T)、黄体生成素(luteinizing hormone,LH)浓度水平比较,观察组显著较对照组低(P<0.05),术后血清T水平显著升高,观察组显著高于对照组(P<0.05);两组患者术后2周内并发症发生情况比较,观察组低于对照组(P<0.05)。结论:相比于腹股沟显微精索静脉结扎术,经外环下精索静脉结扎术更有利于患者精子质量的提高,改善性激素水平,降低患者并发症发生率,值得推广应用。

Objective: To compare and analyze the effects of trans-circumferential spermatic vein ligation and inguinal micro-spermic vein ligation on the semen quality and sex hormone levels of patients with varicocele. Methods: Select from July 2017 to July 2020 A total of 113 patients with varicocele were treated each month as the research object. The patients were divided into observation group(n=57) and control group(n=56) by random number grouping method. The control group was treated with inguinal microspermic vein ligation In the observation group, the spermatic vein ligation was performed under the outer ring. The semen quality,sex hormone levels and complication rate of the two groups were compared. Results: At 6 months after surgery, the sperm density,viability, and percentage of a+b grade sperm in the two groups were significantly increased, and the observation group was not lower than that in the control group(P<0.05);The comparison of serum follicle-stimulating hor-mone(FSH), testoster-one(T) and luteinizing hormone(LH) concentration levels were significantly reduced after surgery, and the observation group was not significantly higher than taht in the control group(P<0.05). The serum T levels of the two groups were significantly increased after surgery, and the observation group was significantly higher. Comparing the complications of scrotal edema, hydrocele, and hydrocele within 2 weeks after operation in the control group(P<0.05), the observation group was not higher than taht in the control group(P<0.05). Conclusion: Compared with inguinal microspermatic vein ligation, subcircumferential spermatic vein ligation is more beneficial to improve the quality of sperm,improve the level of sex hormones, and reduce the incidence of complications in patients, which is worthy of promotion and application.