本文選題：青年 + 精索靜脈曲張��； 參考：《福建醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:通過(guò)meta分析研究青年人群精索靜脈曲張以及精索靜脈曲張治療后的精液質(zhì)量變化。方法:計(jì)算機(jī)檢索Pub Med、Cochrane、Medline,查找所有比較青年人群精索靜脈曲張精液變化及精索靜脈曲張術(shù)后精液變化的隨機(jī)對(duì)照試驗(yàn),檢索時(shí)限為1995年1月1日到2015年1月1日,納入所有比較青年精索靜脈曲張及其治療對(duì)精液影響的隨機(jī)對(duì)照試驗(yàn)。無(wú)論是否提及盲法,要求數(shù)據(jù)詳細(xì)準(zhǔn)確。排除重復(fù)發(fā)表的論文;綜述、評(píng)論或講座;未報(bào)告精子濃度或精子活力的研究;不能提取統(tǒng)計(jì)學(xué)內(nèi)容的研究。將篩選文獻(xiàn)分類入兩個(gè)假設(shè)組中。假設(shè)1(精索靜脈曲張可降低精液質(zhì)量):研究必須包括臨床可診斷的青年男性精索靜脈曲張并有相應(yīng)對(duì)照組。假設(shè)2:(精索靜脈曲張治療可提高精液質(zhì)量):納入的研究可以是參與者的自身對(duì)照或與未治療的青年精索靜脈曲張患者對(duì)照。據(jù)不同的假設(shè)納入排除標(biāo)準(zhǔn)略有差異。按納入排除標(biāo)準(zhǔn)由2人獨(dú)立進(jìn)行隨機(jī)臨床試驗(yàn)(RCT)的篩選、資料提取和質(zhì)量評(píng)價(jià),隨機(jī)對(duì)照試驗(yàn)研究的文獻(xiàn)質(zhì)量使用Jadad Quality。Jadad量表主要項(xiàng)目包括:文獻(xiàn)是否隨機(jī)、是否雙盲、退出和失訪有無(wú)記錄(表1),總分5分,要求納入的文獻(xiàn)評(píng)分不小于3分。文獻(xiàn)由兩例研究者獨(dú)立進(jìn)行質(zhì)量評(píng)價(jià),評(píng)分出現(xiàn)差異時(shí)經(jīng)討論決定取舍。數(shù)據(jù)采用Rev Man5.3軟件進(jìn)行Meta分析。結(jié)果:初步檢索發(fā)現(xiàn)1180篇相關(guān)文獻(xiàn),假設(shè)1(精索靜脈曲張可降低精液質(zhì)量):共納入8個(gè)研究,310位無(wú)曲張患者,165位曲張患者。精子濃度:Std.Mean Difference=0.79,95%CI(0.30-1.29)。合并效應(yīng)量Z=3.16,P值0.05,表明精索靜脈曲張組精子濃度較低。精子活力:Std.Mean Difference=0.62,95%CI(0.18-1.05)。合并效應(yīng)量Z=2.79,P值0.05,精子活力曲張組下降。假設(shè)2:(精索靜脈曲張治療可提高精液質(zhì)量):共納入6個(gè)研究,術(shù)前與術(shù)后精液分析樣本均為160人。精子濃度:Std.Mean Difference=1.4,95%CI(0.30-2.51)。合并效應(yīng)量Z=2.49,P值0.05,精索靜脈曲張治療后精子濃度得到改善。精子活力:Std.Mean Difference=1.47,95%CI(0.14-2.79)。合并效應(yīng)量Z=2.17,P值0.05,表明精索靜脈曲術(shù)后精子活力得到改善。結(jié)論:青年人群中,精索靜脈曲張可對(duì)精子濃度、精子活力產(chǎn)生負(fù)面影響。精索靜脈曲張的治療,可使精子濃度及精子活力得到輕度至中度的提高。早期發(fā)現(xiàn)與合理治療精索靜脈曲張對(duì)于國(guó)人后代健康的意義重大,作為臨床醫(yī)務(wù)工作者,應(yīng)提醒人們關(guān)注青年身體發(fā)育期的各種常見(jiàn)疾病的預(yù)防、診治。
[Abstract]:Objective: to study the semen quality of young people with varicocele and varicocele by meta analysis. Methods: a computer search of Pub Medtrol Cochrane Medline was conducted to find out all the randomized controlled trials in which semen changes of varicocele and semen after varicocele were compared in young population. The search time was from January 1, 1995 to January 1, 2015. All randomized controlled trials were conducted to compare the effects of varicocele and its treatment on semen in young adults. Whether or not the blind method is mentioned, the data are required to be detailed and accurate. Exclusion of repeated papers; reviews, reviews, or lectures; studies that do not report sperm concentration or sperm motility; studies that do not extract statistical content. The sieve literature was classified into two hypothetical groups. Hypothesis 1 (varicocele may reduce semen quality): the study must include clinically diagnosed young men with varicocele and a corresponding control group. Suppose 2: (varicocele treatment improves semen quality: the included study could be a self-control of participants or a control with untreated young patients with varicocele. Inclusion of exclusion criteria varies slightly according to different assumptions. According to the exclusion criteria, two individuals were independently selected for randomized clinical trial (RCT), data extraction and quality evaluation. The main items of literature quality using Jadad Quality.Jadad scale in randomized controlled trial included: whether the literature was random, whether the literature was double-blind or not. There are no records of withdrawal and missing interviews (Table 1, total score 5, required to be included with a document score of not less than 3 points. The literature was evaluated independently by two researchers. The data were analyzed by Meta using Rev Man5.3 software. Results: 1180 related literatures were preliminarily searched, assuming that 1 (varicocele could reduce semen quality): a total of 310 patients with varicocele and 165 patients with varicocele were included in 8 studies. Sperm concentration: Std.Mean difference between 0.79 and 95CI0.30-1.29. The combined effect quantity ZG 3.16 P value was 0.05, which indicated that the spermatozoa concentration of varicocele group was lower than that of varicocele group. Sperm motility: Std.Mean difference between 0.62 and 95CI0.18-1.05. The combined effect of Z _ (2.79) P value was 0.05, and the sperm motility varicose group was decreased. Suppose that 2: 1 (varicocele treatment can improve semen quality): a total of 6 studies were conducted, and 160 semen samples were obtained both before and after operation. Sperm concentration: Std.Mean difference between 1.4 and 95CI 0.30-2.51. The spermatozoa concentration was improved after varicocele treatment. Sperm motility: Std.Mean difference between 1.47 and 95CI0.14-2.79. The combined effect of Z 2. 17 P value was 0. 05, which indicated that sperm motility was improved after spermatic varicocele. Conclusion: varicocele has a negative effect on sperm concentration and sperm motility in young people. The treatment of varicocele can increase sperm concentration and sperm motility mildly to moderately. The early detection and rational treatment of varicocele is of great significance to the health of Chinese offspring. As a clinical medical worker, people should be reminded to pay attention to the prevention, treatment and treatment of various common diseases in the period of physical development of young people.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R697.24

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