三种不同手术方式治疗精索静脉曲张的对比研究.pdf

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1、0静索【摘要】目的比较不同手术方式治疗精索静脉曲张(VC)的临床疗效、并发症及住院总费用。方法对180例原发IttVC患者分别采用3种手术方法治疗，即A组(显微镜手术组)、B组(开放手术组)、C组(腹腔镜手术组)各60例。了解并比较3组患者的手术时间、睾丸动脉保留率、术中出血量、并发症发生率、术后住院时间、住院总费用及术后精液分析指标改善情况。结果A组手术时间较B、C组长，但A组住院时间及住院总费用明显低于B、C组(均P<0．05】。A组动脉保留率明显高于B、C组(P<0．05)。3组术中出血量的差异无统计学意义(P>005o术后A组并发症发生率显著低于B、C组(P<005)，

2、复发率及睾丸萎缩发生率与B、C组无统计学差异(均P>O．05)，术后半年精液分析指标改善情况明显好于B、C组(均P<005o结论3种手术方式治疗精索静脉曲张均有效、简便，但显微镜下精索静脉结扎术与开放手术和腹腔镜手术相比并发症更少、住院时间更短及住院总费用更低、术后恢复更快，更值得临床推广应用。【关键词】精索静脉曲张显微外科腹腔镜手术ComparisonofthreesurgicalmodalitiesfortreatmentofvaricoceleLINLiWUZhigang，WENGZhiliang，eta1．Departmentof，Urology，HuangyanHos

3、piralAffiliatedtoWenzhouMedicalUniversityTaizhou318020，China，【Abstract】ObjectiveTocomparetheapplicationofmicroscopic．1aparoscopicandopenoperationsfortreatmentofvaricoceleMethodsOnehundredandeightypatientswithII～¨ldegreeprimaryvaricoceleunderwentspermaticveinhighligation，withmicroscopic(group

4、A，n=60)，laparoscopic(groupB，n=60)oropen(groupC，n=60)approaches．Thepatientswerefollowedupfor6—24months．Theoperationtime，intraoperativebloodloss，complications，postoperativehospitalizationdays，hospitalizationexpenses，recurrenceandsemenqualitywerecomparedamong3groupsResultsAlloperationswerecompl

5、et——edsuccessfullywithlittlebloodloss．TheoperationtimeofgroupAwaslonger，butthepostoperativehospitalizationdaysandhospitalizationexpenseswerelessthanthoseofgroupsBandC(P<0．05)．Therewasnosignificantdifferenceinaverageintra—operativebloodlossamongthreegroups(P>0．05)．Therateofcomplicationofgroup

6、sA，BandCwas17％(1／60)，217％(13／60)and16_7％(10／60)，respectivelyTherateofreservedarteryingroupsA，Bandwas100．0％，883％and81l7％respectively(groupsAvsgroupBandC，P0．05)Thespermamount，spermden

7、sityandspermmotilityofthreegroupswereincreased6monthsafteroperation(P<0．05)：whiletherateofspermqualityimprovementingroupAwashigherthanthatothertwogroups(P<005)ConclusionAllthreesurgicalmodalitiesofspermaticveinhighligationareeffectivefortreatmentof