精索内静脉高位结扎术治疗精索静脉曲张不育症随机对照研究

本研究在证明女配偶具有正常排卵功能及输卵管通畅的前提下，将６２例Ⅱ°及Ⅱ°以上精索静脉曲张且伴有精液质量低下的不育患者，通过随机抽样方法分为手术组（３１例）与非手术组（３１例），手术组采用经髂窝腹膜外精索内静脉高位结扎术。之后，所有病人均每３月随访１次，共１２月，观察其阴囊皮肤温度、睾丸体积、精液分析、精索静脉管径、有无返流及配偶怀孕等情况。结果表明，手术组病人术后阴囊温度、精液质量等指标改善明显，与非手术组相比有显著性差异（Ｐ＜０．０１）；手术组随访１年累计怀孕率为２９．０３％，而非手术组为１２．９０％。作者认为精索内静脉高位结扎术确可提高精索静脉曲张不育患者的生育力，而血液返流则可能是引起精索静脉曲张不育的重要原因。

Controlled trial of high spermatic vein ligation forvaricocele in infertile men

Sixty-two male patients with infertility caused by varicocele were randomly allocated to operative or non-operative groups. Those patients who were allocated to operative group had received high ligation of the internal spermatic veins. Both groups had been followed up at three monthly intervals for twelve months. At each visit, scrotal thermography, volume of both testes, semen analysis, Doppler test and pregnancy condition of female partners were observed. The results showed that the above mentioned observed items were improved markedly after surgery in operative group, and the difference was significant when compared with non-operative group. Annual pregnancy rates were 29.03% among couples allocated to operative group and 12.90% among those allocated to non-operative group. The results confirmed that high ligation of the internal spermatic veins can improve the fertility in infertile men caused by varicocele, and also suggested the blood reflux might be the basis of infertility in males with varicocele.