使用腹腔镜和开放手术两种不同方法治疗精索静脉曲张的临床效果分析

Clinical Efficacy of Two Different Treatment Methods for Varicocele using Laparoscopy and Open Surgery

目的:分析腹腔镜和开放手术两种不同治疗方法应用于精索静脉曲张患者中的临床应用效果,为临床提供参考。方法:选取2019年6月—2020年10月惠州市中心人民医院博罗分院泌尿外科收治的80例原发性精索静脉曲张患者作为研究对象,按照随机数表法分为对照组和观察组,每组各40例。对照组实施开放手术治疗,观察组实施腹腔镜精索静脉结扎术治疗,比较两组患者各项手术临床指标、临床疗效、精子质量以及术后并发症发生情况。结果:与对照组相比,观察组患者下床活动时间、肠蠕动时间、住院时间、术中出血量以及手术时间均显著缩短,差异有统计学意义(t=8.001、6.146、8.593、21.978、59.696,P<0.05)。术后3个月两组患者精子浓度、向前运动精子百分率以及精子活率均优于术前,差异有统计学意义(t=14.631、21.626、8.403、9.545、8.418、7.376,P<0.05)。结论:腹腔镜精索静脉结扎术与开放手术对精索静脉曲张患者的治疗均疗效显著,两种治疗方案均可提升精子质量,前者在缩短患者的下床活动时间、肠蠕动时间、住院时间以及手术时间均优于后者。

Objective:To analyze the clinical application of two different treatment methods,laparoscopic and open surgery,in patients with varicocele,for clinical reference.Methods:80 patients with primary varicocele admitted to the hospital from June2019 to October 2020 were selected as study subjects and divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was treated with open surgery,and the observation group was treated with laparoscopic spermatorrhaphy ligation.The clinical indexes,clinical efficacy,sperm quality and postoperative complications of the two groups were compared.Results:Compared with the control group,the time to get out of bed,bowel movement time,hospital stay,intraoperative bleeding,and operative time were significantly shorter in the observation group,with statistically significant differences(t=8.001,6.146,8.593,21.978,59.696,P<0.05).The sperm concentration,percentage of forward-moving sperm and sperm viability were better in both groups at 3 months after surgery than before surgery,with statistically significant differences(t=14.631,21.626,8.403,9.545,8.418,7.376,P<0.05).Conclusion:Both laparoscopic spermatic ligation and open surgery are effective in the treatment of patients with varicocele,and both treatment options improve sperm quality,with the former outperforming the latter in reducing time out of bed,bowel movement time,hospital stay,and operative time.