中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
7期
493-495
,共3页
腹腔镜%精索静脉曲张%高选择性%精索静脉高位结扎
腹腔鏡%精索靜脈麯張%高選擇性%精索靜脈高位結扎
복강경%정색정맥곡장%고선택성%정색정맥고위결찰
Laparoscopes%Varicocele%High selective%High ligation of spermatic vein
目的 提高腹腔镜下手术治疗精索静脉曲张水平.方法 2003年7月至2007年10月收治Ⅱ度以上原发性精索静脉曲张患者452例,其中临床随访资料完整337例.左侧285例,双侧52例;曲张Ⅱ度269例,Ⅲ度68例;患侧阴囊坠痛不适238例;婚后不育265例,病程1～13年.其中行腹腔镜下保留精索动脉及淋巴组织的高选择性精索静脉高位结扎术(A组)249例(合并不育197例),行腹腔镜下精索血管集柬结扎术(B组)88例(合并不育68例).统计学分析2组手术时间、术后鞘膜积液、睾丸萎缩、复发等及精液改善和生育情况.结果 337例手术均成功,术后随访2年.2组手术时间分别为(38.0±10.9)min、(19.0±7.5)min,鞘膜积液发生率分别为0.4%(1/249)、11.3%(10/88),睾丸萎缩发生率分别为0.0%(0/249)、3.4%(3/88),术后3个月精液质量提高率分别为77.1%(192/249)、62.5%(55/88),术后2年配偶自然怀孕率分别为56.8%(112/197)、39.7%(27/68),以上指标2组间比较差异均有统计学意义(P<0.05).2组复发率分别为5.6%(14/249)、4.5%(4/88),组间比较差异无统计学意义(P>0.05).结论 腹腔镜下高选择性精索静脉高位结扎术术后并发症发生率低,精液质量提高率和术后2年配偶自然怀孕率高,有推广价值.
目的 提高腹腔鏡下手術治療精索靜脈麯張水平.方法 2003年7月至2007年10月收治Ⅱ度以上原髮性精索靜脈麯張患者452例,其中臨床隨訪資料完整337例.左側285例,雙側52例;麯張Ⅱ度269例,Ⅲ度68例;患側陰囊墜痛不適238例;婚後不育265例,病程1～13年.其中行腹腔鏡下保留精索動脈及淋巴組織的高選擇性精索靜脈高位結扎術(A組)249例(閤併不育197例),行腹腔鏡下精索血管集柬結扎術(B組)88例(閤併不育68例).統計學分析2組手術時間、術後鞘膜積液、睪汍萎縮、複髮等及精液改善和生育情況.結果 337例手術均成功,術後隨訪2年.2組手術時間分彆為(38.0±10.9)min、(19.0±7.5)min,鞘膜積液髮生率分彆為0.4%(1/249)、11.3%(10/88),睪汍萎縮髮生率分彆為0.0%(0/249)、3.4%(3/88),術後3箇月精液質量提高率分彆為77.1%(192/249)、62.5%(55/88),術後2年配偶自然懷孕率分彆為56.8%(112/197)、39.7%(27/68),以上指標2組間比較差異均有統計學意義(P<0.05).2組複髮率分彆為5.6%(14/249)、4.5%(4/88),組間比較差異無統計學意義(P>0.05).結論 腹腔鏡下高選擇性精索靜脈高位結扎術術後併髮癥髮生率低,精液質量提高率和術後2年配偶自然懷孕率高,有推廣價值.
목적 제고복강경하수술치료정색정맥곡장수평.방법 2003년7월지2007년10월수치Ⅱ도이상원발성정색정맥곡장환자452례,기중림상수방자료완정337례.좌측285례,쌍측52례;곡장Ⅱ도269례,Ⅲ도68례;환측음낭추통불괄238례;혼후불육265례,병정1～13년.기중행복강경하보류정색동맥급림파조직적고선택성정색정맥고위결찰술(A조)249례(합병불육197례),행복강경하정색혈관집간결찰술(B조)88례(합병불육68례).통계학분석2조수술시간、술후초막적액、고환위축、복발등급정액개선화생육정황.결과 337례수술균성공,술후수방2년.2조수술시간분별위(38.0±10.9)min、(19.0±7.5)min,초막적액발생솔분별위0.4%(1/249)、11.3%(10/88),고환위축발생솔분별위0.0%(0/249)、3.4%(3/88),술후3개월정액질량제고솔분별위77.1%(192/249)、62.5%(55/88),술후2년배우자연부잉솔분별위56.8%(112/197)、39.7%(27/68),이상지표2조간비교차이균유통계학의의(P<0.05).2조복발솔분별위5.6%(14/249)、4.5%(4/88),조간비교차이무통계학의의(P>0.05).결론 복강경하고선택성정색정맥고위결찰술술후병발증발생솔저,정액질량제고솔화술후2년배우자연부잉솔고,유추엄개치.
Objective To discuss the treatment choices of varicocele by laparoscopic. Methods Retrospective analysis clinical datas of 337 patients with primary varicocele above grade Ⅱ.All of them were treated by operation and followed-up,238 cases had scrotum pain.265 cases were infertility after married.History of diseases was between 1-13 years.249(197 patients with infertility)were treated with laparoscopic high selective ligation of spermatic veins,as Group A.88(68 patiets with infertility)were treated with laparoscopic cluster ligation,as Group B.The clinical data were compared. Results Three hundreds and thirty-seven cases were followed-up 2 years after operation.The operative times of two groups were(38.04±10.9)min、(19.04±7.5)min,the incidences of hydrocelewere 0.4%(1/249),11.3%(10/88);theincidences oftesticular atrophywere 0%(0/249),3.4%(3/88);the improving rates of semen quality in 3 months were 77.1%(192/249),62.5%(55/88);the spontaneous pregnant rates of his spouses in 2 years were 56.8%(112/197),39.7%(27/68).There were significant differences among the 2 groups(P<0.05).The recurrence rates were 5.6%(14/249),4.5%(4/88),there was no significant difference among the 2 groups(P>0.05). Conclusion Laparoscopic high selective ligation of spermatic veins in this study had less complications,higher improving rates of semen quality and pregnant rates.
