上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

显微手术治疗亚临床型精索静脉曲张的效果分析

王 慧1，张 磊2，何学酉2，项雪燕1，牟红云1，刘世雄1   

  1. 1.浙江省台州市中心医院泌尿外科， 台州 318000； 2.中国人民解放军总医院泌尿外科， 北京 100853
  • 出版日期:2015-02-28 发布日期:2015-02-27
  • 作者简介:王 慧（1979—）， 男， 主治医师， 硕士; 电子信箱: wangh1498@enzemed.com。

Analysis of therapeutic effect of microsurgical varicocelectomy on treatment of subclinical varicocele

WANG Hui1, ZHANG Lei2, HE Xue-you2, XIANG Xue-yan1, MOU Hong-yun1, LIU Shi-xiong1   

  1. 1.Department of Urology， Taizhou Central Hospital， Taizhou 318000， China; 2.Department of Urology， General Hospital of Chinese PLA， Beijing 100853， China
  • Online:2015-02-28 Published:2015-02-27

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摘要：

目的 观察显微镜下精索静脉结扎术治疗亚临床型精索静脉曲张的效果。方法 依据临床查体和超声检查结果，将40例患者分为亚临床型精索静脉曲张组（SVc）（20例）和临床型精索静脉曲张组（CVc）（20例）。所有患者经显微镜下精索静脉结扎术治疗，分别比较术前组间精液参数差异和组内术前、术后3个月的精液参数。采集精液参数主要包括精子密度、精子活动率和精子活力。收集患者术后3个月时的复发与并发症情况。结果 术前患者年龄、组间各精液参数差异均无统计学意义（P>0.05），但SVc组的平均静脉内径值小于CVc组[分别为(2.62±0.39) mm和(4.09±0.86) mm, P<0.05]。SVc组术后3个月的各精液参数较术前均无明显改善（P>0.05），而CVc组的各精液参数则术后均比术前有明显改善（P<0.05）。40例患者术后均未发现复发及睾丸萎缩、阴囊疼痛、睾丸鞘膜积液等并发症。结论 显微外科手术不能改善亚临床型精索静脉曲张患者的精液质量，但能缓解患者的术前存在的阴囊不适症状。

关键词: 亚临床型精索静脉曲张, 显微外科, 精液质量

Abstract:

Objective To observe the therapeutic effect of microsurgical varicocelectomy for the treatment of subclinical varicocele. Methods According to results of physical examinations and color Doppler flow imaging (CDFI), 40 patients were divided into the subclinical varicocele (SVc) group (n=20) and clinical varicocele (CVc) group (n=20). All patients underwent microsurgical varicocelectomy. Semen parameters of two groups before the surgery and semen parameters of patients of the same group before and 3 months after the surgery were compared. The main semen parameters were sperm concentration, sperm motility, and sperm viability. The recurrence and complications of patients 3 months after the surgery were collected. Results The differences of preoperative age and semen parameters of two groups were not statistically significant (P>0.05), but the mean inner diameter of spermatic vein of the SVc group was smaller than that of the CVc group [(2.62±0.39) mm and (4.09±0.86) mm, respectively, P<0.05]. Semen parameters of the SVc group 3 months after the surgery were not significantly better than those before the surgery (P>0.05), while semen parameters of the CVc group 3 months after the surgery were significantly better than those before the surgery (P<0.05). The recurrence and complications of testicular atrophy, testis pain, and hydrocele were not found in all 40 patients 3 months after the surgery. Conclusion Microsurgical varicocelectomy can not improve the seminal quality of patients with subclinical varicocele, but can relieve the preoperative scrotum complaints.

Key words: subclinical varicocele, microsurgery, seminal quality