CAJ | 학술논문

目的探讨多普勒超声测量睾丸包膜动脉血流动力学参数在评判外环下显微手术治疗精索静脉曲张疗效的价值.方法2011年12月至2012年4月我院共实施外环下显微手术治疗左侧精索静脉曲张手术32例,分别应用彩色多普勒超声测量患者术前及术后3个月、6个月的睾丸包膜动脉的血流动力学参数(收缩期峰值流速、舒张末期流速、阻力指数、搏动指数).同时测量患者术前及术后6个月精液质量指标.结果术后不同时间与术前比较,左侧睾丸包膜动脉的收缩期峰值流速在术后下降(P<0.05、P<0.01),舒张末期流速在术后明显增加(P<0.05、P<0.01),阻力指数及搏动指数明显下降(P<0.05、P<0.01).术后6个月精子的数量及活动力不同程度地提高(P<0.01),但精子质量指标与血流动力学参数间未发现相关关系(P>0.05).结论睾丸包膜动脉舒张末期血流速度的增加及包膜动脉阻力指数、搏动指数的下降提示术后睾丸组织内微循环的改善,这些参数可以较好地提示手术疗效.
목적탐토다보륵초성측량고환포막동맥혈류동역학삼수재평판외배하현미수술치료정색정맥곡장료효적개치.방법2011년12월지2012년4월아원공실시외배하현미수술치료좌측정색정맥곡장수술32례,분별응용채색다보륵초성측량환자술전급술후3개월、6개월적고환포막동맥적혈류동역학삼수(수축기봉치류속、서장말기류속、조력지수、박동지수).동시측량환자술전급술후6개월정액질량지표.결과술후불동시간여술전비교,좌측고환포막동맥적수축기봉치류속재술후하강(P<0.05、P<0.01),서장말기류속재술후명현증가(P<0.05、P<0.01),조력지수급박동지수명현하강(P<0.05、P<0.01).술후6개월정자적수량급활동력불동정도지제고(P<0.01),단정자질량지표여혈류동역학삼수간미발현상관관계(P>0.05).결론고환포막동맥서장말기혈류속도적증가급포막동맥조력지수、박동지수적하강제시술후고환조직내미순배적개선,저사삼수가이교호지제시수술료효.
Objective To investigate the value of testicular capsular artery blood flow parameters in judging the outcome of microsurgical subinguinal varicocelectomy. Methods Total of 32 patients with left varicocele who underwent microsurgical subinguinal varicocelectomy in our hospital from December 2011 to April 2012 were enrolled in the study all the patients were examined 3 times with color Doppler sonography(CDS) for testicular blood flow parameters(peak systolic velocity, end diastolic velocity, resistive index, and pulsatility index) before operation, and 3 months 6 months after operation respectively. The parameters were measured from capsular artery. Preoperative and postoperative semen parameters were also evaluated. Results Compared with that of preoperation,the mean values of blood flow velocities(peak systolic and end diastolic) decreased and increased respectively(P<0.05, P<0.01) in the left capsular artery, and resistance indices (resistive and pulsatility) decreased after surgery (P<0.05, P<0.01). At 6th month after operation, sperm amount and motility all increased significantly (P<0.01). However, no significant correlation was found between sperm parameters and blood flow parameters(P>0.05). Conclusion The increase in blood flow velocity and decrease in resistive and pulsatility indices of the capsular artery may be indicators of an improvement in testicular microcirculation.Testicular blood flow parameters can be used for evaulating the outcome of microsurgical subinguinal varicocelectomy.