腹膜后精索静脉高位结扎术联合药物治疗精索静脉曲张所致不育55例临床观察

目的：观察腹膜后精索静脉高位结扎术联合药物治疗精索静脉曲张（ VC）所致不育的临床疗效。方法将106例VC所致不育患者随机分为2组，治疗组55例应用腹膜后精索静脉高位结扎术联合药物治疗，对照组51例单纯应用腹膜后精索静脉高位结扎术治疗。观察2组术后3、6、9、12个月精液参数，术后随访3～24个月观察配偶妊娠率。结果2组手术后精液参数均较本组手术前提高（ P＜0．05）；治疗组手术后6个月精液参数较本组手术后3个月提高（P＜0．05）；治疗组手术后6、9、12个月精液参数比较差异无统计学意义（P＞0．05）；对照组手术后9个月精液参数较本组手术后6个月提高（P＜0．05）；对照组手术后9、12个月精液参数比较差异无统计学意义（P＞0．05）。治疗组手术后6个月精液参数较对照组同期提高（P＜0．01）。治疗组配偶妊娠率高于对照组（P＜0．01）。结论 VC所致不育患者腹膜后精索静脉高位结扎术联合药物治疗较单纯腹膜后精索静脉高位结扎术治疗能更明显、更快速地改善精液质量和提高配偶妊娠率。

Treatment of varicocele-caused infertility by retroperitoneal varicocele high ligation combined with drug treatment

Objective To observe the clinical effect of retroperitoneal varicocele high ligation combined with drug treatment on varicocele -caused infertility .Methods 106 infertility patients caused by varicocele were ran-domly divided into two groups .55 cases in treatment group were treated by retroperitoneal varicocele high ligation combined with drug treatment .51 cases in control group received only retroperitoneal varicocele high ligation .The se-men quality and enhance spouse pregnancy were observed in two groups at 3,6,9,12,18 months after surgery.The spouse pregnancy were recorded post -operation follow-up of 3-24 months.Results The seminal parameter post-operation were enhanced as compared with those before operation in two groups （P〈0.05）.The seminal parameter at six months post-operation were enhanced as compared with those at three months post operation in treatment group （P〈0.05）.There was no difference between the seminal parameters at six ,nine and twelve months post -operation in treatment group （P〉0.05）.The seminal parameter at nine months post -operation were enhanced as compared with those at six months post operation in control group （P〈0.05）.There was no difference between the seminal pa-rameters at nine and twelve months post -operation in control group （P〉0.05）.The seminal parameter in treatment group at six months post -operation were enhanced as compared with those in control group （P〈0.01）.The im-provement of the spouse pregnancy in treatment group was superior to that in control group （ P〈0 .01 ） .Conclusion Retroperitoneal varicocele high ligation combined with drug treatment can more effectively and rapidly improve se -men qualityand enhance spouse pregnancy .