CAJ | 학술논문

目的探讨应用超声探查曲张的精索静脉在腹股沟走行的局部解剖关系,以设计精索静脉曲张高位结扎的体表微创切口定位的可行性.方法随机选择60例精索静脉曲张患者并与传统手术定位方法35例精索静脉曲张患者进行对照.改进方法采用彩色多普勒超声探查精索静脉在腹股沟管内的深浅走行,设计微创切口是以股动脉为体表标志,精索静脉穿行腹股沟管跨越股动脉形成的垂直交叉点,平行上移1 cm为切口的起点,以此起点向外上方做一条与腹股沟韧带平行并呈30°夹角的约2.0 cm长的切口,这个切口距传统的内环口定位略低1 cm.同期传统手术是以耻骨节结与髂前上棘连线中点稍上方2.0 cm处为起点,取与腹股沟韧带平行切口5 cm.结果微创组60例患者手术切口平均2.1 cm,手术时间平均22 min,住院时间平均为3.5 d.传统组手术切口平均5.5 cm,手术时间平均48 min,住院时间平均为6.5 d.结论超声定位下微创切口入路精索静脉相对表浅,手术创口微小、操作简便、时间缩短、定位准确.
목적 탐토응용초성탐사곡장적정색정맥재복고구주행적국부해부관계,이설계정색정맥곡장고위결찰적체표미창절구정위적가행성.방법 수궤선택60례정색정맥곡장환자병여전통수술정위방법35례정색정맥곡장환자진행대조.개진방법채용채색다보륵초성탐사정색정맥재복고구관내적심천주행,설계미창절구시이고동맥위체표표지,정색정맥천행복고구관과월고동맥형성적수직교차점,평행상이1 cm위절구적기점,이차기점향외상방주일조여복고구인대평행병정30°협각적약2.0 cm장적절구,저개절구거전통적내배구정위략저1 cm.동기전통수술시이치골절결여가전상극련선중점초상방2.0 cm처위기점,취여복고구인대평행절구5 cm.결과 미창조60례환자수술절구평균2.1 cm,수술시간평균22 min,주원시간평균위3.5 d.전통조수술절구평균5.5 cm,수술시간평균48 min,주원시간평균위6.5 d.결론 초성정위하미창절구입로정색정맥상대표천,수술창구미소、조작간편、시간축단、정위준학.
Objective In order to choose the best surgical approach for minimally trauma varicocelectomy color Doppler ultrasound(CDU) was used to detect the anatomic relationships of spermatic vein in groin. Methods Sixty varicocele patients were randomly selected. Their spermatic veins were examined by CDU which beginning from superficial inguinal ring,passing the crossing point of spermatic vein and femoral artery ,and ending at the 3cm above the deep inguinal ring. The depths from skin to spennatic vein were measured and the relationships between spermatic vein and femoral artery were recorded. Results The average length of incision is 2.1cm and the average duration of operation is 22 minutes. The average depth from skin to spermatic vein was 1.1cm,1.55cm and 3.56cm respectively at the site of the superficial inguinal ring,the crossing point of spermatic vein and femoral artery,and the deep ingui-nal ring. Conclusion The best approach for minimally trauma varicocelectomy is at the crossing point of spermatic vein and femoral artery because here the spermatic vein is relative superficial and has merged into two or three vessels and the femoral artery can be easily touched by fingers.