精索内静脉-腹壁下静脉双flow-through超引流技术治疗精索静脉曲张应用解剖

Anatomical study on the application of double flow-through super drainage technique of internal spermatic vein-inferior epigastric vein in the treatment of varicose veins of the spermatic cord

目的观察成人腹壁下血管穿过腹股沟区域时的直径、血流速度、血管位置、血管长度,为精索静脉曲张双flow-through超引流技术提供解剖依据。方法2023年7月至2023年11月在武汉大学中南医院对30例年龄在20~30岁之间的成年男性进行B超检查,测量腹壁下静脉,腹壁浅静脉直径、血流速度,计量资料以均数±标准差(±s)表示,并进行文献查阅,查出腹壁下血管在腹股沟区域的走行及精索静脉曲张时的静脉管径及流速。并且在两具人体标本上进行精索内静脉-腹壁下静脉双flow-through超引流模拟手术,总结经验,得出较好的手术方法。组间比较采用t检验。结果通过B超测得的腹壁下动脉直径[(2.3±0.2)mm]大于腹壁浅动脉[(1.4±0.2)mm,t=10.312,P<0.01],腹壁下静脉直径[(2.2±0.4)mm]大于腹壁浅静脉直径[(1.3±0.2)mm,t=5.533,P<0.01]。腹壁下动脉流速[(3.81±0.84)cm/s]小于腹壁浅动脉流速[(4.33±0.61)cm/s,t=-1.505,P>0.05],腹壁下静脉流速[(1.77±0.23)cm/s]小于腹壁浅静脉流速[(3.03±0.58)cm/s,t=-6.017,P<0.01]。结论精索静脉曲张腹壁下静脉双flow-through超引流技术临床应用价值较高。

Objective To observe the diameter,blood flow velocity,vessel location,and vessel length of the inferior epigastric veins as they pass through the inguinal region in adults and to provide an anatomical basis for the technique of double flow-through ultrasound drainage of varicocele.Methods Color Doppler testing of 30 adult males aged 20-30 years at Zhongnan Hospital of Wuhan University from July 2023 to November 2023 to measure the diameters of the inferior epigastric vein,the superficial epigastric vein,and the blood flow velocity,Measurements are expressed as mean±standard deviation(±s),and a literature review was conducted to find out the alignment of the inferior epigastric vessels in the inguinal region and the venous diameters and flow velocities of the veins in the case of spermatic varicose veins.The simulated surgery of double flow-through super drainage of internal spermatic vein-the inferior epigastric vein was performed on two human specimens to summarize the experience and arrive at a better surgical method.The t-test was used to compare the measurement data.Results The diameters of the inferior epigastric artery,the inferior epigastric vein[(2.3±0.2),(2.2±0.4)mm]were larger than the diameters of the superficial epigastric artery and the superficial epigastric vein[(1.4±0.2),(1.3±0.2)mm,t=10.312,5.533,P<0.01].The flow velocities of the inferior epigastric artery and the inferior epigastric vein[(3.81±0.84),(1.77±0.23)cm/s]were smaller than the flow velocities of the superficial epigastric artery and the superficial epigastric vein[(4.33±0.61),(3.03±0.58)cm/s,t=-1.505,-6.017,P>0.05,P<0.01].The inferior epigastric vein was more fixed in position and had a larger diameter.Therefore,the inferior epigastric vein was one of the most suitable veins for double flow-through super drainage of the spermatic vein-inferior epigastric vein.Conclusion The double flow-through super drainage technique of the inferior epigastric vein for varicocele has a high clinical value.