显微外科曲张精索静脉结扎术对精索静脉曲张的疗效分析

目的：探讨分析显微外科曲张精索静脉结扎术对精索静脉曲张的临床疗效.方法：回顾性分析我院2010年3月至2012年4月收治的精索静脉曲张性不育患者106例,入院后随机将患者分为两组,其中53例为A组行显微外科精索静脉结扎术,剩余53例为B组行腹腔镜下精索血管集束结扎术,比较两组手术效果以及术后并发症发生情况.结果：A组手术时间明显大于B组,而两组住院时间比较差异不显著.两组术前精液各项指标比较差异不显著,而术后3个月精液分析各项指标均较术莆得到改善,A组精子数量和精子活率均显著高于B组,差异均具有统计学意义（P＜0.05）.术后3个月两组精子密度和（a＋b）级精子数比较差异不显著,无统计学意义（P＞0.05）.两组术前精液各项指标比较差异不显著,而术后3个月精液分析各项指标均较术前得到改善,A组精子数量和精子活率均显著高于B组,差异均具有统计学意义（P＜0.05）.术后3个月两组精子密度和（a＋b）级精子数比较差异不显著,无统计学意义（P＞0.05）.结论：显微外科曲张静脉精索结扎术相比于腹腔镜下精索血管集束结扎术虽然手术时间长,但是对患者损伤小,所以精子质量改善情况较好,并发症发生率及复发率都较低,值得在临床上推广.

The efficacy of microsurgical spermatic vein ligation in the treatment of varicocele

Objectives： To investigate the clinical efficacy of microsurgical spermatic vein ligation in the treatment of var- icocele. Method： We conducted a retrospective analysis of 106 patients treated in our hospital from March 2010 to April 2012 for varicocele infertility. They were randomly divided into two groups, 53 cases in each group. Group A received the microsur- gical spermatic vein ligation, and Group B received the laparoscopic cluster ligation of spermatic vessels. The surgical results and postoperative complications were compared between the two groups. Results： The operation time of Group A was longer compared with Group B. However, there was no significant difference in the hospital stay. Preoperative semen indicators showed no statistically significant difference. Three months after the surgery, semen indicators of both groups improved, and the sperm count and sperm motility of Group A were significantly higher compared with Group B （ P 〈 0. 05 ）. The sperm density and （ a ＋ b） sperm count had no statistically significant difference between the two groups （ P 〉 0. 05 ）. Conclusion： Microsur- gical spermatic vein ligation operation is worth clinical practice as it causes less injury and improves the sperm quality with lower recurrence rate and occurrence rate of complications despite the fact that it is more time - consuming than laparoscopic cluster ligation of spermatic vessels.