医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2013年
36期
167-169
,共3页
陈进渠%刘汉昌%万正华%邬宇龙%陈魁夫%肖继光
陳進渠%劉漢昌%萬正華%鄔宇龍%陳魁伕%肖繼光
진진거%류한창%만정화%오우룡%진괴부%초계광
目的:探讨腹腔镜“裸”静脉结扎术治疗精索静脉曲张的疗效。方法:收集我院自2006年1月至2013年9月接受曲张精索静脉结扎术患者资料共计213,根据不同的手术方法分为开放高位结扎组(32例)、腹腔镜精索血管聚束结扎(82例)、腹腔镜精索“裸”静脉结扎组(99例),对其手术前后精液分析报告、术后精索静脉曲张复发、术后早期并发症等方面的数据进行回顾性分析。结果:患者平均年龄26.12岁(13-61岁);其中不育症就诊138例、阴囊局部胀痛不适就诊41例;术前精液分析报告显示异常者(少、弱、畸形精子症等)171例,其中术后3个月有一项精液质量指标改善者152例(失访42例),改善率在高位结扎组、腹腔镜聚束结扎组和腹腔镜“裸”静脉结扎组分别为58.33%(14/24)、67.44%(29/43)、81.99%(69/85,P<0.05);术前诊断依据为体格检查和彩超,术后6月彩超提示复发者在3组分别为12.5%(3/24)、0%(0/43)、2.35%(2/85,P<0.05);术后早期并发症在高位结扎组:阴囊水肿6例(25.0%)、睾丸鞘膜积液1例(4.17%);腹腔镜聚束结扎组:阴囊水肿5例(8.06%)、阴囊疼痛12例(19.35%);腹腔镜“裸”静脉结扎组:阴囊水肿4例(4.71%),无其他并发症。结论:腹腔镜手术创伤小,术后恢复快,术后并发症少于开放组,改善率优于开放组,易于患者接受。腹腔镜“裸”静脉结扎术在对精液分析参数的改善、术后并发症方面明显优于高位结扎组和腹腔镜聚束结扎组。
目的:探討腹腔鏡“裸”靜脈結扎術治療精索靜脈麯張的療效。方法:收集我院自2006年1月至2013年9月接受麯張精索靜脈結扎術患者資料共計213,根據不同的手術方法分為開放高位結扎組(32例)、腹腔鏡精索血管聚束結扎(82例)、腹腔鏡精索“裸”靜脈結扎組(99例),對其手術前後精液分析報告、術後精索靜脈麯張複髮、術後早期併髮癥等方麵的數據進行迴顧性分析。結果:患者平均年齡26.12歲(13-61歲);其中不育癥就診138例、陰囊跼部脹痛不適就診41例;術前精液分析報告顯示異常者(少、弱、畸形精子癥等)171例,其中術後3箇月有一項精液質量指標改善者152例(失訪42例),改善率在高位結扎組、腹腔鏡聚束結扎組和腹腔鏡“裸”靜脈結扎組分彆為58.33%(14/24)、67.44%(29/43)、81.99%(69/85,P<0.05);術前診斷依據為體格檢查和綵超,術後6月綵超提示複髮者在3組分彆為12.5%(3/24)、0%(0/43)、2.35%(2/85,P<0.05);術後早期併髮癥在高位結扎組:陰囊水腫6例(25.0%)、睪汍鞘膜積液1例(4.17%);腹腔鏡聚束結扎組:陰囊水腫5例(8.06%)、陰囊疼痛12例(19.35%);腹腔鏡“裸”靜脈結扎組:陰囊水腫4例(4.71%),無其他併髮癥。結論:腹腔鏡手術創傷小,術後恢複快,術後併髮癥少于開放組,改善率優于開放組,易于患者接受。腹腔鏡“裸”靜脈結扎術在對精液分析參數的改善、術後併髮癥方麵明顯優于高位結扎組和腹腔鏡聚束結扎組。
목적:탐토복강경“라”정맥결찰술치료정색정맥곡장적료효。방법:수집아원자2006년1월지2013년9월접수곡장정색정맥결찰술환자자료공계213,근거불동적수술방법분위개방고위결찰조(32례)、복강경정색혈관취속결찰(82례)、복강경정색“라”정맥결찰조(99례),대기수술전후정액분석보고、술후정색정맥곡장복발、술후조기병발증등방면적수거진행회고성분석。결과:환자평균년령26.12세(13-61세);기중불육증취진138례、음낭국부창통불괄취진41례;술전정액분석보고현시이상자(소、약、기형정자증등)171례,기중술후3개월유일항정액질량지표개선자152례(실방42례),개선솔재고위결찰조、복강경취속결찰조화복강경“라”정맥결찰조분별위58.33%(14/24)、67.44%(29/43)、81.99%(69/85,P<0.05);술전진단의거위체격검사화채초,술후6월채초제시복발자재3조분별위12.5%(3/24)、0%(0/43)、2.35%(2/85,P<0.05);술후조기병발증재고위결찰조:음낭수종6례(25.0%)、고환초막적액1례(4.17%);복강경취속결찰조:음낭수종5례(8.06%)、음낭동통12례(19.35%);복강경“라”정맥결찰조:음낭수종4례(4.71%),무기타병발증。결론:복강경수술창상소,술후회복쾌,술후병발증소우개방조,개선솔우우개방조,역우환자접수。복강경“라”정맥결찰술재대정액분석삼수적개선、술후병발증방면명현우우고위결찰조화복강경취속결찰조。
Objective To explore the clinical results of laparoscopic internal spermatic vein high ligation. Methods Selected 213 patients with primary varicocele in our hospital From January 2006 to September 2013 Al of them were conducted laparoscopic varicocele high ligation(32 cases in open operation , 82 cases in laparoscopic cluster ligation with suture , 99 cases in laparoscopic high ligation of internal spermatic vein). The quality of spermium, recurrence rate, and complications were compared and analyzed retrospectively. Results Average 26.12 ages, infertility(138 cases),scrotum testicular(41 cases),abnormal spermium(171 cases). 3 months after surgery, 171 cases were reviewed,sperm quality were obvious improved. The rates of semen quality improvement were 58.33%(14/24)、67.74%(42/62)、and81.18%(69/85,P<0.05);,6 months after surgery, The rates of recurrence were 12.5%(3/24)、0%(0/62)and2.35%(2/85,P<0.05) respectively, in open operation, in laparoscopic cluster ligation with suture and laparoscopic high ligation of internal spermatic vein(P<0.05). In open operation:The early complications of surgery were 6 cases of scrotum(25.0%),2 case of hydrocele (4.17%).In laparoscopic cluster ligation with suture: 5 cases of scrotal edema (8.06%),12case of scrotum testicular (19.35%).In laparoscopic high ligation of internal spermatic vein:4 cases of scrotum(4.71%),no other complications. Conclusions Laparoscopic high ligation of internal spermatic vein is the better therapy on varicocele in improving sperm quality and decreasing complications. Laparoscopic varicocele high ligation is safe,reliable, satisfactory, and quicker recovery.