两种术式治疗精索静脉曲张疗效的比较

目的对比分析显微镜下精索内静脉低位结扎与传统Palomo术式治疗精索静脉曲张的手术并发症发生率及精子质量改善情况。方法研究对象为西京医院收治的142例精索静脉曲张患者，其中68例接受了显微镜下精索静脉低位结扎术（A组），74例接受了传统的Palomo术式（B组），对两组手术时间、并发症发生率以及术前、术后精液分析结果进行对比分析。结果A组手术时间（53±11）min，B组手术时间（22±7）min，A组长于B组，P〈0．05；术后并发症两组比较，A组阴囊水肿4例（5．8％），附睾炎4例（5．8％），B组阴囊水肿15例（20．3％），附睾炎9例（12．2％），两组术后并发症发生率差异有统计学意义，P〈0．05；两组术后精子质量均有显著改善，但A组术后精子计数、密度、活力和活率均明显高于B组，A组术后精子计数（43．00±4．31）×10。、活率（65．00±4．55）％，B组术后精子计数（37．20±5．45）×10。、活率（53．34±6．73）％，P〈0．05。结论显微镜下精索内静脉低位结扎术治疗精索静脉曲张术后并发症少，精子质量改善程度优于传统Palomo术式。

Comparison of the efficacy of two approaches of varicocelectomy for the treatment of varicocele

Objective To evaluate the effects of low-approach microsurgical varicocelectomy and traditional Palomo operation in the treatment of varicocele. Methods 142 inpatients with varicocele were divided into group A （68 patients who underwent low-approach micro-surgical varicocelectomy） and group B （74 patients who underwent traditional Palomo operation）. The operation time, complications and semen quality before and after operation were analyzed. Results The operation time of group A was longer than that of group B （53 ± 11 ）min vs. （22 ± 7）min, P〈0.05）], but the incidence of testicular atrophy, scrotal edema, epididymitis, hydrocele testis and recurrence in group A was lower than that in group B group A： 4 cases of scrotal edema （5.8%）, 4 cases of epididymitis （5.8% ） ; group B： 15 cases of scrotal edema （20.3% ）, 9 cases of epididymitis （12.2 %）, P〈0. 05）]. Three months after operation, the sperm amount, sperm density, semen quality and sperm motility of the two groups were enhanced. Every semen parameter of group A was better than group B （group A.. sperm amount： （43.00±4.31）× 10^6 , sperm motility （65.00±4.55） % ; group B： sperm amount （37.20±5.45）×10^6 , sperm motility （53.34±6.73）%, P〈0.05）]. Conclusion Low-approach microsurgical varicocelectomy showed great advantages over traditional Palomo operation in reducing complications and enhancing semen quality.