显微镜下精索静脉低位结扎术与腹腔镜下精索静脉高位结扎术治疗精索静脉曲张患者的效果

Effect of Low Ligation of Spermatic Veins under Microscope and High Ligation of Spermatic Veins under Laparoscope in the Treatment of Patients with Varicocele

目的:分析显微镜下精索静脉低位结扎术与腹腔镜下精索静脉高位结扎术治疗精索静脉曲张(varicocele,VC)患者的效果。方法:选取2018年6月—2022年6月漳浦县医院收治的60例VC患者。根据计算机数字排列法随机将其分为观察组和对照组,各30例。对照组实施腹腔镜下精索静脉高位结扎术,观察组实施显微镜下精索静脉低位结扎术。比较两组术前,术后1个月、3个月、6个月精液质量参数,围手术期指标,并发症及复发率。结果:术后1个月、3个月、6个月,观察组精子密度、精子个数、精子活力、正常形态精子占比均显著高于对照组,差异有统计学意义(P<0.05)。观察组手术时间长于对照组,术中出血量多于对照组,术后住院时间短于对照组,术后3 d视觉模拟评分法(visual analogue scale,VAS)评分、治疗费用均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率及复发率均显著低于对照组,差异有统计学意义(P<0.05)。结论:显微镜下精索静脉低位结扎术的有效性与安全性高于腹腔镜下精索静脉高位结扎术,可减少患者的治疗费用,缩短住院时间、且手术创伤小。

Objective:To analyze the effect of low ligation of spermatic veins under microscope and high ligation of spermatic veins under laparoscope in the treatment of patients with varicocele(VC).Method:A total of 60 VC patients admitted to Zhangpu County Hospital from June 2018 to June 2022 were selected.The patients were randomly and equally divided into observation group and control group according to the computer numerical arrangement method,with 30 cases in each group.The control group underwent high ligation of spermatic veins under laparoscope,and the observation group underwent low ligation of spermatic veins under microscope.Semen quality parameters before surgery,1 month,3 months and 6 months after surgery,perioperative indexes,complications and recurrence rates were compared between the two groups.Result:At 1 month,3 months and 6 months after surgery,sperm density,sperm number,sperm motility and proportion of normal sperm morphology sperm in observation group were significantly higher than those in control group,the differences were statistically significant(P<0.05).The surgery time of the observation group was longer than that of the control group,the amount of intraoperative blood loss was more than that of the control group,the postoperative hospitalization time was shorter than that of the control group,and the visual analogue scale(VAS)score at 3 d after surgery and treatment cost were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of complications and recurrence rate in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The efficacy and safety of low ligation of spermatic vein under microscope is relatively higher than that of high ligation of spermatic vein under laparoscopy,which can reduce the treatment expenses of patients,shorten the hospitalization time,with small surgical trauma.