腹腔镜下精索静脉高位结扎术、改良Palomo术和经腹股沟管精索静脉结扎治疗精索静脉曲张的疗效对比

目的探讨腹腔镜下精索静脉高位结扎术、改良Palomo术和经腹股沟管精索静脉结扎术治疗精索静脉曲张的疗效对比。方法回顾性分析2010年2月²014年2月期间在我院就诊的120例精索静脉曲张患者,其中行腹腔镜下精索静脉高位结扎术40例(腹腔镜组)、行改良Palomo术40例(改良组)、行经腹股沟管精索静脉结扎术40例(常规组),对比三组患者的手术时间、住院天数以及术后疗效。结果三组患者在手术时间、住院时间均无显著性差异(p>0.05),术后3个月、6个月时精液质量均较治疗前有显著改善(p<0.05),但三组组内比较3个月、6个月时精液质量无显著性差异(p>0.05)。而常规组患者手术复发率显著高于腹腔镜组和改良组(p<0.05)。结论精索静脉曲张患者采用腹腔镜下精索静脉高位结扎术、改良Palomo术和经腹股沟管精索静脉结扎术治疗均能取得较好的治疗效果,而对于双侧的曲张患者,建议选择腹腔镜手术。

THE COMPARATIVE OF THE CLINICAL EFFECTS OF LAPAROSCOPIC HIGH LIGATION IN VARICOCELECTOMY,MODIFIED PALOMO PROCEDURE AND INGUINAL VARICOCELECTOMY

Objective To explore the clinical effects of laparoscopic high ligation of varicocele,modified Palomo procedure and inguinal varicocelectomy. Methods 120 cases of varicocele in our hospital from February 2012 to February2014 were equally assigned into laparoscopic high ligation of varicocele（ laparoscopic group）,modified Palomo procedure（control group） and inguinal varicocelectomy（control group）. The three groups were compared in terms of operation time,hospitalization days and postoperative effect. Results Three groups had no significant differences in operation time and hospitalization time（p 〉 0. 05）. Semen quality was significantly improved after 3 months and 6 months（ p 〈 0. 05）. But semen quality had no significant difference among the groups（ p〉0. 05）. Postoperative recurrence rate of conventional group was obviously higher than that in other groups（ p 〈 0. 05）. Conclusion The three methods all have good therapeutic efficacy,however,for bilateral varicose patients,laparoscopic operation is the best.