| 赵 娜,徐 磊,林宏云,陈文道,王文婷,刘德胜.三种不同手术方式治疗精索静脉曲张患者的临床研究[J].,2020,(6):1155-1158 |
| 三种不同手术方式治疗精索静脉曲张患者的临床研究 |
| Clinical Study of Three Different Surgical Methods for Varicocele |
| 投稿时间：2019-07-06 修订日期：2019-07-30 |
| DOI：10.13241/j.cnki.pmb.2020.06.035 |
| 中文关键词: 腹膜后高位结扎术 腹腔镜手术 显微手术 精索静脉曲张 疗效 |
| 英文关键词: Retroperitoneal high ligation Laparoscopic surgery Microsurgery Varicocele Curative effect |
| 基金项目:海南省卫生计生行业科研项目（16A211091） |
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| 中文摘要: |
| 摘要 目的：研究三种不同的手术方式治疗精索静脉曲张患者（VC）的临床疗效。方法：选择2015年1月至2017年6月在我院接受VC手术的患者128例进行研究，其中接受腹膜后高位结扎术者45例，纳入腹膜后组；接受腹腔镜手术者39例，纳入腹腔镜组；接受显微手术者44例，纳入显微手术组，对比各组患者的手术时间、出血量、住院时间及住院总费用，对比术前、术后3个月各组的睾丸体积、性激素水平，随访1年，记录各组复发率和并发症发生情况。结果：显微手术组的手术时间长于腹膜后组与腹腔镜组，出血量、住院时间、住院总费用少于腹膜后组与腹腔镜组（P<0.05）。术前、术后3个月各组左侧、右侧睾丸体积对比差异均无统计学意义（P>0.05）。术后3个月各组睾酮（T）水平高于术前，卵泡刺激素（FSH）、黄体生成素（LH）水平低于术前（P<0.05），术后3个月显微手术组T水平高于腹膜后组与腹腔镜组，FSH、LH水平低于腹膜后组与腹腔镜组（P<0.05）。与腹膜后组、腹腔镜组相比，显微手术组的复发率及并发症发生率更低（P<0.05）。结论：不同手术方案治疗VC均可获得一定的疗效，但显微术式可明显改善性激素水平，降低复发率及并发症发生率，术后恢复好，费用少。 |
| 英文摘要: |
| ABSTRACT Objective: To study the clinical effect of three different surgical methods in the treatment of patients with varicocele (VC). Methods: 128 cases of patients underwent VC surgery in our hospital from January 2015 to June 2017 as the research objects. Among which there were 45 patients underwent retroperitoneal high ligation, named as retroperitoneal group; 39 patients underwent laparoscopic surgery, named as laparoscopic group; 44 patients underwent microsurgery, named as microsurgery group. The operation time, bleeding volume, hospitalization time and total hospitalization expenses of each group were compared. The testicular volume and sex hormone levels of each group before surgery and 3 months after surgery were compared. The recurrence rate and complications of each group were recorded after one year follow-up. Results: The operation time of the microsurgery group was longer than that of the retroperitoneal group and the laparoscopic group, and the amount of bleeding, hospitalization time and total hospitalization cost of the microsurgery group were less than those of the retroperitoneal group and the laparoscopic group(P<0.05). There was no significant difference in the volume of left and right testicles between the two groups before and 3 months after surgery(P>0.05). 3 months after surgery, the level of testosterone (T) in each group was higher than that before surgery, and the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in each group were lower than those before surgery(P<0.05). 3 months after surgery, the levels of T in microsurgery group were higher than those in retroperitoneal group and laparoscopic group, and the levels of FSH and LH were lower than those in retroperitoneal group and laparoscopic group(P<0.05). Compared with retroperitoneal group and laparoscopic group, the recurrence rate and complication rate of microsurgery group were lower(P<0.05). Conclusion: Different surgical procedures can achieve certain curative effect in the treatment of VC, but microsurgery can significantly improve the level of sex hormones, reduce the recurrence rate and the incidence of complications, recover well and cost less. |
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