李亞琦

[摘要] 目的 分析腹腔鏡下高選擇性曲張靜脈結(jié)扎術(shù)治療精索靜脈曲張的臨床效果。方法 方便選取該院在2017年9月—2018年5月期間收治的90例精索靜脈曲張患者作為該次的研究對象，對其病例資料進(jìn)行回顧性分析，依據(jù)手術(shù)方式的不同進(jìn)行分組，一組給與腹腔鏡下高選擇性曲張靜脈結(jié)扎術(shù)，為實(shí)驗(yàn)組，一組給與顯微鏡下低位精索靜脈結(jié)扎術(shù)，為常規(guī)組，比較兩組患者的治療效果。結(jié)果 實(shí)驗(yàn)組患者手術(shù)時間為（60.4±6.4）min，手術(shù)費(fèi)用為（16 453.5±474.5）元，住院時間為（3.3±2.3）d，其中手術(shù)時間較常規(guī)組更短（t=21.641 3，P<0.05），其他數(shù)據(jù)比較差異無統(tǒng)計學(xué)意義（t=2.106 7、0.674 6，P>0.05）;實(shí)驗(yàn)組患者術(shù)后6個月精子濃度、a+b級精子百分率與常規(guī)組比較差異無統(tǒng)計學(xué)意義（t=1.805 2、1.446 3，P>0.05）;實(shí)驗(yàn)組患者復(fù)發(fā)率為13.33%（6例），高于常規(guī)組的2.22%（1例）（χ2=3.872 6，P<0.05）。結(jié)論 腹腔鏡下高選擇性曲張靜脈結(jié)扎術(shù)治療精索靜脈曲張療效顯著，手術(shù)時間較短，但復(fù)發(fā)率較高，臨床中建議依據(jù)患者個體差異和需求理性選擇手術(shù)方案。

[關(guān)鍵詞] 腹腔鏡下高選擇性曲張靜脈結(jié)扎術(shù);精索靜脈曲張;顯微鏡下低位精索靜脈結(jié)扎術(shù);臨床效果

[中圖分類號] R699? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）09（a）-0033-03

[Abstract] Objective To analyze the clinical effect of laparoscopic high-selective variceal ligation in the treatment of varicocele. Methods 90 patients with varicocele admitted to this hospital from September 2017 to May 2018 were convenient selected as the subjects of this study. The medical records were retrospectively analyzed and grouped according to the different surgical methods. Laparoscopic high-selective variceal ligation was performed in the experimental group， and a group of low-grade spermatic vein ligation under the microscope was given to the conventional group to compare the therapeutic effects of the two groups. Results The operation time of the experimental group was （60.4±6.4） min， the operation cost was （16 453.5±474.5） yuan， and the hospitalization time was （3.3±2.3）d. The operation time was shorter than the conventional group （ t= 21.641 3，P<0.05）， there was no statistically significant difference in other data（t=2.106 7，0.674 6，P>0.05）. There was no statistically significantdifference in sperm concentration and a+b sperm percentage between the experimental group and the conventional group （t=1.805 2，1.446 3，P>0.05）; the recurrence rate of the experimental group was 13.33% （6 cases）， which was 2.22% （1 case） higher than that of the conventional group （χ2=3.872 6，P<0.05）. Conclusion Laparoscopic highly selective variceal ligation is effective in the treatment of varicocele. The operation time is shorter， but the recurrence rate is higher. It is recommended to choose the surgical plan according to the individual differences and needs of the patients.

[Key words] Laparoscopic high-selective variceal ligation; Varicocele; Low-grade spermatic vein ligation under microscope; Clinical effect

精索靜脈曲張是臨床中常見的男科疾病，將對患者的生育功能產(chǎn)生一定程度的影響，并可引起陰囊區(qū)不適，目前普遍通過手術(shù)方式治療[1-3]。腹腔鏡下高選擇性曲張靜脈結(jié)扎術(shù)在臨床中較為常用，而近幾年，隨著顯微鏡技術(shù)的發(fā)展，顯微鏡下低位精索靜脈結(jié)扎術(shù)也受到了臨床中的關(guān)注，但仍有部分學(xué)者認(rèn)為腹腔鏡下高選擇性曲張靜脈結(jié)扎術(shù)療效較為顯著[4-5]。該次研究的目的就在于分析腹腔鏡下高選擇性曲張靜脈結(jié)扎術(shù)治療精索靜脈曲張的臨床效果，并對2017年9月—2018年5月期間該院收治的90例精索靜脈曲張患者的病例資料進(jìn)行了回顧性分析，現(xiàn)報道如下。