本文選題：腹腔鏡手術(shù) + 精索靜脈曲張�。� 參考：《中國微創(chuàng)外科雜志》2017年06期

【摘要】：目的探討腹腔鏡下精索血管集束高位結(jié)扎和腹腔鏡下保留睪丸動脈精索內(nèi)靜脈高位結(jié)扎術(shù)治療精索靜脈曲張的術(shù)后精液參數(shù)變化及并發(fā)癥。方法回顧性分析2012年9月~2015年3月我院行腹腔鏡精索靜脈高位結(jié)扎術(shù)的精索靜脈曲張94例資料,其中腹腔鏡精索血管集束高位結(jié)扎術(shù)45例(A組),腹腔鏡下保留睪丸動脈精索內(nèi)靜脈高位結(jié)扎術(shù)49例(B組),比較2組術(shù)后6個月精液參數(shù)的變化以及術(shù)后并發(fā)癥。結(jié)果術(shù)后隨訪8~56個月,平均26個月。術(shù)后6個月A、B組精液質(zhì)量較術(shù)前均有明顯改善,且術(shù)后精子數(shù)量[(35.9±2.1)×10~6vs.(44.9±2.3)×10~6,t=-19.541,P=0.000],精子密度[(25.6±2.1)×10~6/ml vs.(28.1±2.9)×10~6/ml,t=-4.874,P=0.000],精子活力(56.2%±3.3%vs.66.9%±4.0%,t=-14.124,P=0.000),B組明顯好于A組。術(shù)后陰囊水腫[20.0%(9/45)vs.6.1%(3/49),χ~2=4.057,P=0.044],繼發(fā)性鞘膜積液[17.8%(8/45)vs.4.1%(2/49),χ~2=4.629,P=0.031],附睪炎[24.4%(11/45)vs.6.1%(3/49),χ~2=6.212,P=0.013],睪丸萎縮[8.9%(4/45)vs.0%(0/49),Fisher檢驗,P=0.049],術(shù)后總并發(fā)癥[73.3%(33/45)vs.20.4%(10/49),χ~2=26.674,P=0.000],A組均明顯高于B組;2組術(shù)后精索靜脈曲張復發(fā)率[2.2%(1/45)vs.4.1%(2/49),χ~2=0.262,P=0.608]無明顯差異。術(shù)后自然妊娠率[40.0%(18/45)vs.73.5%(36/49),χ~2=10.749,P=0.001],B組明顯高于A組。結(jié)論術(shù)中保留睪丸動脈有益于提高精液質(zhì)量和自然妊娠率,減少術(shù)后睪丸萎縮、附睪炎、陰囊水腫。
[Abstract]:Objective to investigate the changes of semen parameters and complications in the treatment of varicocele by laparoscopic high ligation of spermatic vessels and high ligation of testicular artery. Methods from September 2012 to March 2015, 94 cases of varicocele underwent laparoscopic varicocele ligation in our hospital were retrospectively analyzed. There were 45 cases of group A with high ligation of spermatic cord and 49 cases of group B with high ligation of testicular artery. The semen parameters and complications were compared 6 months after operation in group 2. Results the follow-up was 8 ~ 56 months (mean 26 months). At 6 months after operation, the semen quality of group A was significantly improved than that of before operation, and the sperm quantity [35.9 鹵2.1) 脳 10~6vs.(44.9 鹵2.3) 脳 10 ~ (-6) ~ (-19.541) P ~ (0.000), sperm density [25.6 鹵2.1) 脳 10~6/ml vs.(28.1 鹵2.9) 脳 106ml ~ (-4.874) P _ (0.000), sperm motility 56.2% 鹵3.3vs.66.9% 鹵4.0 ~ (-1) P 0.000 in group B were significantly better than those in group A. 鏈悗闃村泭姘磋偪[20.0%(9/45)vs.6.1%(3/49),蠂~2=4.057,P=0.044],緇у彂鎬ч灅鑶滅Н娑瞇17.8%(8/45)vs.4.1%(2/49),蠂~2=4.629,P=0.031],闄勭澗鐐嶽24.4%(11/45)vs.6.1%(3/49),蠂~2=6.212,P=0.013],鐫句父钀庣緝[8.9%(4/45)vs.0%(0/49),Fisher媯，

本文編號：2017773