显微镜与腹腔镜下精索静脉结扎术治疗精索静脉曲张的疗效及并发症的对比观察

《显微镜与腹腔镜下精索静脉结扎术治疗精索静脉曲张的疗效及并发症的对比观察》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、显微镜与腹腔镜下精索静脉结扎术治疗精索静脉曲张的疗效及并发症的对比观察龙纪明纪德阳（四川省成都天大不孕不育医院外科610041）【摘要】目的：比较经显微外科与腹腔镜途径精索静脉结扎术治疗精索静脉曲张的疗效及并发症。方法：将86例精索静脉曲张患者随机分为显微外科精索静脉结扎术组（43例）和腹腔镜精索静脉结扎术组（43例），比较术前、术后3个月的精液质量、术后并发症、术后配偶妊娠率。结果：显微外科组手术时间明显长于腹腔镜组（p<0.05）;术后住院天数显微外科组为（3.6&plUsmn;0.7）d，腹腔镜组为（2.8±0.8）d

2、,两组无明品差别；两组术后精子密度、活率、a+b级精子百分率均较前明显提高（p〈0.05），但两组间无统计学差异。配偶妊娠率显微外科组为65.2%,腹腔镜组为62.4%。术后一周内阴囊水肿发生率显微外科组为6.97%,腹腔镜组为9.30%;术后睾丸鞘膜积液发生率显微外科组为0例，腹腔镜组为1例（2.32%）；术后复发率均为0例。（p>0.05）结论：与腹腔镜精索静脉结扎术比，显微外科精索静脉结扎术创伤更小，恢复快、麻醉经济、术后并发症少、复发率低，是值得推广的安全有效的术式。【关键词】精索静脉曲张显微外科腹腔镜疗效并发症【中图分类号】R6

3、99.1【文献标识码】A【文章编号】2095-1752（2013）05-0102-03Microscopicversuslaparoscopicvaricocelectomyinthetreatmentofvaricocele;EffectsandcomplicationsLongjiming,jideyang【Abstract】Objective:Tocomparetheeffectsandpostoperativecomplicationsofmicroscopicvaricocelectomy(MV)andlaparoscopicv

4、aricocelectomy(LV)inthetreatmentofvaricocele.Methods:Weassigned86varicocelepatientstotwogroupsofequalnumbertobetreatedbyMVandLV.Wecomparedthetwogroupsinthesemenparametersbeforeand3monthsaftersurgery,postoperativecomplications,andpregnancyratesofthepatients'wives.Results:T

5、heoperativetimewassignificantlylongerintheMVthanintheLVgroup(p<0.05).ThepostoperativehospitalstayshowednosignificantdifferencebetweentheMVandLVgroups(3.2±0.7)dvs(2.8±0.8)d.spermconcentration,spermmotilityandthepercentageofgradea+bspermweresingnificantlyincre

6、asedinbothgroupsaftersurgery(p<0.05),butwithnosignificantdifferencesbetweenthetwo.Thepregnancyratewas65.2%intheformerand62.4%inthelatter.Postoperativehydroceleoccurredin2casesintheLV,butnoneintheMVgroup.Therewerenostatisticallysignificantdifferencesinrecurrencebetweenthet

7、wogroups(p〉0.05).Conclusion:MVissuperiortoLVforitsminimalinvasiveness,economicalanesthesia,fasterrecoveryandlowerratesofpostoperativecomplicationsandrecurrence.【keywords】varicocelemicrosurgerylaparoscopytherapeuticeffectcomplication精索静脉曲张是临床常见病，就是精索内蔓状静脉丛异常扩张、迂曲成团。主要表现为阴囊

8、坠胀不适，潮湿、疼痛和男性不育，常见于青壮年。是导致男性不育的常见疾病。原发不育患者约35%伴有精索静脉曲张，而继发性不育患者可高达70%-81%[1]。精索静脉曲张引起不育的原因是精索静脉冋