腹腔镜治疗精索静脉曲张术后复发的临床效果分析

目的比较腹腔镜手术和开放手术治疗精索静脉曲张术后复发患者的临床效果。方法原发性精索静脉曲张术后复发患者64例,随机分为两组,其中腹腔镜组32例,开放组32例,对比研究两组的手术时间、出血量、术后体温、肠道功能恢复时间、术后住院时间等。术后随访3个月,分析两组之间术后近、远期并发症、复发率及术后精液改善情况等指标。结果腹腔镜组手术时间、术中失血量、肠道功能恢复时间、术后住院时间明显少于开放组,差异有统计学意义(P<0.05)。两组术后体温差异无统计学意义(P>0.05);腹腔镜组急性睾丸痛发生率及静脉曲张复发率低于开放组(P<0.05),而鞘膜积液及睾丸萎缩发生率差异无统计学意义(P>0.05);与开放组相比,腹腔镜组的精子活力改善更为明显(P<0.05),但两组间精子密度及活动率差异无统计学意义(P>0.05),住院综合治疗费用两组无显著差异(P>0.05)。结论腹腔镜精索静脉高位结扎术治疗精索静脉曲张具有创伤小、疗效好、并发症少等优点,值得临床推广。

Analysis of the Efficacy ofLaparoscopic Ligation of Spermatic Vein for the Treatment to Varicocele with Recurrent

Objective To investigate the therapeutic effect of laparoscope operation and spermatic veins operation in treatmem of varicocele with recurrent. Method Totally 64 primary varicocele patients with recurrent were randomly divided into 2 groups. 32 cases were in laparoscopic group and 32 cases were in open group. The operating time, blood loss, temperature after operation, functional recovery time of intestinal tract, postoperative hospital stay in 2 groups were comparatively studied, followed up for 3 months ,the early and long term complications, the rate of recurrence and the quality of semen were analyzed. Results The operating time, blood loss, functional recovery time of intestinal tract and the hospital stay in laparoscopic group was much less than that in open group, the difference between the two groups was significant（P〈0.05）. And temperature after operation showed no statistically significant difference between the two groups（P〉0.05）, the incidence of complications after operation such as acute orchidalgia and the rate of recurrence in laparoscopic group were tower than that in open group （P〈0.05）. And the incidence of hydrocele and orchiatrophy after operation were not significant different in the two groups （P〉0.05）. As compared with open group.the activity of sperm was obviously improved in the laparoscope group after operation（P〈0.05）. The count and vigour of sperm after operation showed no statistically significant difference between the two groups（P〉0.05）. There was no differences in the hospitalization fee between two groups（P〉0.05）. Conclusion Laparoscopic ligation of spermatic vein has the advantages of minimal trauma, good curative effect, less complication.It is worth to be extended in clinics.