CAJ | 학술논문

目的总结精索静脉曲张(VC)诊断和治疗的经验.方法对810例VC患者行经皮小切口腹膜外超选择性精索静脉结扎术,对比分析VC手术前后精索内静脉内径、睾丸体积、精液质量和性激素的变化.结果术后5～30天,疼痛不适等症状消失426例(63.7％).曲张的静脉内径小于1.8mm 710例(88.1％),大于1.8mm 96例(11.9％).506例L- VC患者睾丸容积平均为16.5 +2.8ml,小于正常(20ml).198例VC伴不育患者术后6个月精子密度、a+b级精子和精子活率改善率分别为48.1％、57％和61％.198例VC所致不育患者,术后半年～2年,52例妊娠,受孕率26.9％.结论 VC引起不育和疼痛需手术治疗.精索内静脉高位结扎术能明显改善精子质量和缓解疼痛等症状.经皮小切口腹膜外超选择性精索静脉结扎术创伤小、显露清楚、并发症少、复发率低.
목적 총결정색정맥곡장(VC)진단화치료적경험.방법 대810례VC환자행경피소절구복막외초선택성정색정맥결찰술,대비분석VC수술전후정색내정맥내경、고환체적、정액질량화성격소적변화.결과 술후5～30천,동통불괄등증상소실426례(63.7％).곡장적정맥내경소우1.8mm 710례(88.1％),대우1.8mm 96례(11.9％).506례L- VC환자고환용적평균위16.5 +2.8ml,소우정상(20ml).198례VC반불육환자술후6개월정자밀도、a+b급정자화정자활솔개선솔분별위48.1％、57％화61％.198례VC소치불육환자,술후반년～2년,52례임신,수잉솔26.9％.결론 VC인기불육화동통수수술치료.정색내정맥고위결찰술능명현개선정자질량화완해동통등증상.경피소절구복막외초선택성정색정맥결찰술창상소、현로청초、병발증소、복발솔저.
Objectives To summarise the experiences in diagnosis and treatment of varicocele(VC).Methods 810 cases of ectoperitoneal ultra - selective high spermatic vein ligation via minimal skin incision were analysed retrospectively to study the interior diameters of spermatic vein,spermary volume,quality of sperm and the changes of sexual hormone before and after surgical treatment.Results In 5～10 days after operation,symptoms such as pain disappeared in 213 cases(63.7％).The average testicular volume in 511 L-VC patients is 16.5±2.8 ml (＜20ml).The interior diameter of spermatic vein＜1.8 mm in 714 Vc patients ( 88.1％),and the interior diameter of spermatic vein＞ 1.gmm in 96 Vc patients (11.9％).In 6 months after operation,the improvement rate on sperm density,average percentage of A + B level sperm activity,and sperm activity were 48.1％,57％and 61％ respectively.In 198 varicocele and infertile patients,there were 104 patients whose wife was pregnant from half year to 2years after operation,and the conception rate is 26.9％.Conclusions In VC patients suffering from male infertility and pain,operation needs to be considered.varicocele high ligation can significantly improve sperms - quality and lessen the pain.Ectoperitoneal ultra - selective high spermatic vein ligation via minimal skin incision has advantages of minimal invasiveness,safety,lower complication,and lower recurrence.