两种微创手术方式治疗精索静脉曲张的效果

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摘要目的探讨腹腔镜精索静脉高位结扎术和显微镜下精索静脉低位结扎术两种手术方式治疗精索静脉曲张的效果。方法选取2014年6月~2016年6月解放军第一〇五医院收治的80例精索静脉曲张患者，按随机数字表法分为腹腔镜组和显微镜组，每组各40例，分别采用腹腔镜和显微镜两种手术方式。观察两组的手术时间、术中出血量、术后住院时间，并比较术后并发症、复发率及精液质量改善状况。结果两组术后的精液质量显著高于术前，显微镜组精液质量改善程度优于腹腔镜组，差异有统计学意义（P ＜ 0.05)。显微镜组的手术时间显著长于腹腔镜组，差异有统计学意义（P ＜ 0.05)。术中出血量及术后出院时间比较，差异无统计学意义（P > 0.05）。显微镜组术后并发症发生率显著低于腹腔镜组，差异有统计学意义（P ＜ 0.05)。结论腹腔镜精索静脉高位结扎术和显微镜下精索静脉低位结扎术都是临床上治疗精索静脉曲张安全且有效的方式。相比于腹腔镜手术，显微镜手术具有术后并发症发生率低，且精液质量改善明显等优势，值得优先推广应用。

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	孟杰李海波李超志

关键词 ：精索静脉曲张, 腹腔镜, 显微镜, 精索静脉结扎术

Abstract：Objective To investigate the efficacy of two minimally invasive procedures for the treatment of varicocele. Methods From June 2014 to June 2016, 80 patients with varicocele at the 105th Hospital of PLA were randomly divided into laparoscopic group and microscope group according to random number table, witn 40 cases in each group, and treated by microscopic and laparoscopic varicocelectomy respectively. The semen parameters before and after surgery, operation time, intraoperative blood loss, postoperative hospital stay and postoperative complications and recurrence rate were measured respectively. Results Semen quality was significantly increased in both groups after surgery, and the improvement of semen quality was better than that of the laparoscopic group (P ＜ 0.05). The operation time of the microscope group was significantly longer than that of the laparoscopic group, with statistically significant difference (P < 0.05). There was no significant difference in intraoperative blood loss and postoperative hospital stay (P > 0.05). The incidence of postoperative omplications in the microscope group was significantly lower than that in the laparoscopic group, with statistically significant difference (P < 0.05). Conclusion Microscopic versus laparoscopic varicocelectomy are safe and effective ways to treat varicocele. Microscopic varicocelectomy is superior to laparoscopic varicocelectomy for its significantly improved semen quality and lower rates of postoperative complications．

Key words： Varicocele Laparoscopy Microscope Varicocelectomy

通讯作者: 李海波（1977.2-），男，硕士，副主任医师；研究方向：男科学。

引用本文:

孟杰李海波李超志. 两种微创手术方式治疗精索静脉曲张的效果[J]. 中国医药导报, 2017, 14(15): 86-89.
MENG Jie LI Haibo LI Chaozhi. Efficacy evaluation of two minimally invasive procedures for the treatment of varicocele. 中国医药导报, 2017, 14(15): 86-89.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I15/86

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