CAJ | 학술논문

目的：分析腹腔镜精索静脉高位结扎术治疗静脉曲张的可行性、有效性以及较传统手术的优越性。方法回顾分析整群选取2010年10月—2013年12月期间，该院收治的患男性不育及确诊为精索静脉曲张的病人298例，按单纯随机抽样的方法分为两组，腹腔镜组病人158例，给予经腹腔镜下精索静脉高位结扎术；传统手术组病人140例给予传统的经腹股沟途径精索静脉高位结扎术，观察临床疗效，并分析对比两种方法的有效性及并发症发生状况。结果两组手术时间、术中出血量、住院时间差异有统计学意义（t值分别为16.56、125.92、9.78，P＜0.01）；术后有效性：腹腔镜组优于传统手术组，差异有统计学意义（χ2=6.75,P＜0.01）；精液参数比较：腹腔镜组优于传统手术组，差异有统计意义（χ2＝6.08，P＜0.01）；并发症发生率：传统组较腹腔镜组发生率高，差异有统计学意义（χ2＝9.98，P＜0.01）。结论腹腔镜下精索静脉曲张高位结扎术，较传统腹股沟入路手术具有手术时间短，治愈率高，术后恢复快，对机体创伤小，并发症少等优点，是一种安全可靠的手术方法，可作为治疗精索静脉曲张的首选方法。
목적：분석복강경정색정맥고위결찰술치료정맥곡장적가행성、유효성이급교전통수술적우월성。방법회고분석정군선취2010년10월—2013년12월기간，해원수치적환남성불육급학진위정색정맥곡장적병인298례，안단순수궤추양적방법분위량조，복강경조병인158례，급여경복강경하정색정맥고위결찰술；전통수술조병인140례급여전통적경복고구도경정색정맥고위결찰술，관찰림상료효，병분석대비량충방법적유효성급병발증발생상황。결과량조수술시간、술중출혈량、주원시간차이유통계학의의（t치분별위16.56、125.92、9.78，P＜0.01）；술후유효성：복강경조우우전통수술조，차이유통계학의의（χ2=6.75,P＜0.01）；정액삼수비교：복강경조우우전통수술조，차이유통계의의（χ2＝6.08，P＜0.01）；병발증발생솔：전통조교복강경조발생솔고，차이유통계학의의（χ2＝9.98，P＜0.01）。결론복강경하정색정맥곡장고위결찰술，교전통복고구입로수술구유수술시간단，치유솔고，술후회복쾌，대궤체창상소，병발증소등우점，시일충안전가고적수술방법，가작위치료정색정맥곡장적수선방법。
Objective To analyze the feasibility and validity of laparoscopic high ligation in the treatment of varicocele and its superiority over traditional surgery. Methods A retrospectively analysis was done on 298 male patients with varicocele-induced infertility who were admitted and confirmed in this hospital between October 2010 and December 2013. They were randomized to underwent laparoscopic high ligation (the laparoscopic group, n=158) and conventional high ligation through inguinal approach (the conventional group, n=140). The clinical efficacy was observed, and the validity and complications were compared between the two procedures. Results There were statistically significant differences in operative duration, intraop-erative blood loss, length of hospital stay between the two groups, t=16.56, 125.92, 9.78 respectively, P<0.01. In terms of validity, the laparoscopic group was higher than the conventional group, and the difference was statistically significant (χ2=6.75, P<0.01); in terms of semen parameters, the laparoscopic group was superior to the conventional group, and the difference was statistically significant (χ2=6.08, P<0.01);in terms of complication rates, the conventional group was higher than the la-paroscopic group, and the difference was statistically significant (χ2=9.98, P<0.01). Conclusion Compared with conventional high ligation through inguinal approach, laparoscopic high ligation in the treatment of varicocele has the advantages of shorter operative duration, , fewer complications, high cure rate, quicker recovery, , small trauma. This safe and reliable operation method can be used as the preferred one.