CAJ | 학술논문

目的：观察腹腔镜单、双侧精索内、外静脉同时结扎对精索静脉曲张患者血清生殖激素及睾丸生精功能的影响。方法选择2010年1月~2014年11月本院收治的67例双侧精索静脉曲张(右侧亚临床型)患者，将其随机分为单侧组(35例)与双侧组(32例)，单侧组行单侧精索静脉结扎，双侧组行双侧精索静脉结扎，观察两组血清卵泡刺激素(FSH)和黄体生成素(LH)、睾丸生精功能术前、术后的变化及临床症状的改变。结果两组血清FSH和LH术后较术前均明显降低(P<0.05)，但两组间术后FSH和LH差异无统计学意义(P>0.05)；两组精液中精子密度、精子活率、精子活动力a级+b级所占比例术后较术前均明显升高(P<0.05)，但术后两组间差异无统计学意义(P>0.05)。两组患者术后都临床症状均明显改善，且并发症少、轻，复发率低。结论双侧精索静脉曲张患者(右侧亚临床型)腹腔镜精索内、外静脉同时结扎治疗能显著降低血清FSH和LH水平，改善睾丸生精功能，消除临床症状，但双侧结扎并没有比单侧结扎有更大的优势。
목적：관찰복강경단、쌍측정색내、외정맥동시결찰대정색정맥곡장환자혈청생식격소급고환생정공능적영향。방법선택2010년1월~2014년11월본원수치적67례쌍측정색정맥곡장(우측아림상형)환자，장기수궤분위단측조(35례)여쌍측조(32례)，단측조행단측정색정맥결찰，쌍측조행쌍측정색정맥결찰，관찰량조혈청란포자격소(FSH)화황체생성소(LH)、고환생정공능술전、술후적변화급림상증상적개변。결과량조혈청FSH화LH술후교술전균명현강저(P<0.05)，단량조간술후FSH화LH차이무통계학의의(P>0.05)；량조정액중정자밀도、정자활솔、정자활동력a급+b급소점비례술후교술전균명현승고(P<0.05)，단술후량조간차이무통계학의의(P>0.05)。량조환자술후도림상증상균명현개선，차병발증소、경，복발솔저。결론쌍측정색정맥곡장환자(우측아림상형)복강경정색내、외정맥동시결찰치료능현저강저혈청FSH화LH수평，개선고환생정공능，소제림상증상，단쌍측결찰병몰유비단측결찰유경대적우세。
Objective To observe the effect of serum reproductive hormone and testis spermatogenesis on varicocele patients by unilateral or bilateral laparoscopic simultaneous ligation of internal and exteral spermatic veins. Methods 67 patients with two sided varicocele all have a sub-clinical varicocele on the right side in our hospital from January 2010 to November 2014 were selected and divided into unilateral group(35 cases) and bilateral group(32 cases) in ran-dom.The unilateral group was operated unilateral ligation of spermatic vein in the unilateral group, bilateral group was operated bilateral ligation of spermatic vein in the bilateral group.Serum follicle stimulating hormone (FSH) level and luteinizing hormone (LH) level and testis spermatogenesis in two groupswas compared,and the change of clinical symp-toms was also observed. Results The serum levels of FSH and LH in two groups were significantly reduced at post-surgery than that at pre-surgery (P<0.05),there was no significantly difference in the levels of FSH and LH between two groups after surgery (P>0.05).The sperm concentration,sperm motility and sperm vitality (class a+class b) in two groups were significantly increased at post-surgery than that at pre-surgery (P<0.05),there was no significantly difference be-tween two groups after surgery(P>0.05).The clinical symptoms in two groups were much relieved after surgery,and oper-ation complications were few and no severe,and low recurrence rate. Conclusion Unilateral or bilateral laparoscopic si-multaneous ligation of internal and exteral spermatic veins in patients with two sided varicocele all have a sub-clinical varicocele on the right side can reduce the levels of serum FSH and LH,improve testis spermatogenesis,relive clinical symptoms.However,bilateral ligation of spermatic veins is no more advantage than unilateral ligation of spermatic vein.