低位显微外科与腹腔镜精索静脉结扎术治疗精索静脉曲张性不育临床效果对比
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摘要
目的对比分析精索静脉曲张性不育患者采用低位显微外科与腹腔镜精索静脉结扎术治疗的临床效果。方法从该院在2016年8月—2017年7月时间段内诊治的精索静脉曲张性不育患者当中随机选取50例作为研究对象,随机对患者进行编号,1～50号,其中奇数号为对照组(25例),采用腹腔镜+传统高位结扎术治疗,偶数号为观察组(25例),采用低位显微外科手段治疗,对比两组治疗的临床效果。结果治疗前对照组和观察组患者的精子密度和精子总数相比差异无统计学意义(t=0.146 3,0.534 2,P>0.05),治疗后6个月,对照组和观察组患者的精子密度和精子总数均明显升高,治疗前后对比差异有统计学意义(t=8.356 6,9.625 6;t=9.366 2,9.747 4,P<0.05),两组间对比差异无统计学意义(t=0.546 6,0.845 6,P>0.05);观察组和对照组并发症发生率分别为4.00%和20.00%,两组对比差异有统计学意义(χ~2=16.946 5,P<0.05);对患者随访1年,观察组没有发现复发病例,对照组出现2例(8.0%)复发病例,两组对比差异有统计学意义(χ~2=4.684 3,P<0.05)。结论对精索静脉曲张性不育患者采用低位显微外科与腹腔镜精索静脉结扎术联合传统高位结扎术都可以取得较为理想的治疗效果,但是低位显微外科对患者造成的创伤更小,并发症少,更值得在临床上推广和应用。
Objective To compare and analyze the clinical effect of low-approach microsurgery and laparoscopic varicocele ligation in treatment of varicocele infertility. Methods 50 cases of patients with varicocele infertility diagnosed and treated in our hospital from August 2016 to July 2017 were selected and randomly divided into two groups and randomly divided into two groups with 25 cases in each, the control group were treated with laparoscope and traditional high ligation, while the observation group were treated with low-approach microsurgery, and the clinical effect was compared between the two groups. Results Before treatment, there were no statistically significant differences in the sperm density and sperm count between the two groups(t=0.146 3,0.534 2, P >0.05), after 6-month treatment, the sperm density and sperm count of the two groups obviously increased, and the differences before and after treatment were statistically significant(t=8.356 6,9.625,6; t=9.366 2,9.747 4, P<0.05), and the differences between the two groups were not statistically significant(t=0.546 6,0.845 6, P>0.05); and the incidence rate of complications in the observation group and in the control group was respectively 4.00% and 20.00%, and the difference between the two groups was statistically significant(χ~2=16.946 5, P<0.05), and there were no recurrent cases in the observation group,and 2 recurrent cases 8.0% in the control group after 1-year follow-up, and the difference between the two groups was statistically significant(χ~2=4.684 3, P<0.05). Conclusion The low-approach microsurgery, laparoscopic varicocele ligation combined with traditional high ligation of patients with varicocele infertility can obtain an ideal effect, but the wound of low-approach microsurgery to patients is smaller, and the complications are fewer, and it is worth clinical promotion and application.
Objective To compare and analyze the clinical effect of low-approach microsurgery and laparoscopic varicocele ligation in treatment of varicocele infertility. Methods 50 cases of patients with varicocele infertility diagnosed and treated in our hospital from August 2016 to July 2017 were selected and randomly divided into two groups and randomly divided into two groups with 25 cases in each, the control group were treated with laparoscope and traditional high ligation, while the observation group were treated with low-approach microsurgery, and the clinical effect was compared between the two groups. Results Before treatment, there were no statistically significant differences in the sperm density and sperm count between the two groups(t=0.146 3,0.534 2, P >0.05), after 6-month treatment, the sperm density and sperm count of the two groups obviously increased, and the differences before and after treatment were statistically significant(t=8.356 6,9.625,6; t=9.366 2,9.747 4, P<0.05), and the differences between the two groups were not statistically significant(t=0.546 6,0.845 6, P>0.05); and the incidence rate of complications in the observation group and in the control group was respectively 4.00% and 20.00%, and the difference between the two groups was statistically significant(χ~2=16.946 5, P<0.05), and there were no recurrent cases in the observation group,and 2 recurrent cases 8.0% in the control group after 1-year follow-up, and the difference between the two groups was statistically significant(χ~2=4.684 3, P<0.05). Conclusion The low-approach microsurgery, laparoscopic varicocele ligation combined with traditional high ligation of patients with varicocele infertility can obtain an ideal effect, but the wound of low-approach microsurgery to patients is smaller, and the complications are fewer, and it is worth clinical promotion and application.
引文
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[8]张治国,张文达,史振铎,等.显微镜外环下精索静脉结扎术治疗精索静脉曲张性不育的临床观察[J].中国保健营养,2016,26(30):58-59.
[9]田汝辉,李朋,王俊龙,等.精索静脉显微结扎术联合七叶皂苷治疗精索静脉曲张的有效性与安全性[J].中华医学杂志,2015,95(36):2910-2913.
[10]王健富,刘东,吴家清,等.低位显微外科与腹腔镜精索静脉结扎术对精索静脉曲张性不育的疗效对比[J].中国医学创新,2018,15(5):34-37.
[2]朱少明,程帆.精索静脉曲张致不育机制的研究进展[J].安徽医药,2017,21(11):1945-1949.
[3]田华晓.两种精索静脉结扎术治疗精索静脉曲张性不育的效果比较[J].国际泌尿系统杂志,2016,36(3):395-398.
[4]李程.腹腔镜精索静脉高位结扎术治疗精索静脉曲张性不育的临床效果观察[J].中国医药指南,2017,15(26):137-138.
[5]陈旭.腹腔镜高位结扎术治疗精索静脉曲张性不育患者的疗效分析[J].医药前沿,2016,6(19):19-20.
[6]黄小军,李虎宜,梁志恒,等.腹腔镜精索静脉高位结扎术对单侧精索静脉曲张伴不育患者精液参数的影响研究[J].国际检验医学杂志,2017,38(15):2046-2047,2050.
[7]谷傲峥.腹腔镜精索静脉高位结扎术治疗精索静脉曲张性不育的研究[J].中国社区医师,2015,31(12):50,52.
[8]张治国,张文达,史振铎,等.显微镜外环下精索静脉结扎术治疗精索静脉曲张性不育的临床观察[J].中国保健营养,2016,26(30):58-59.
[9]田汝辉,李朋,王俊龙,等.精索静脉显微结扎术联合七叶皂苷治疗精索静脉曲张的有效性与安全性[J].中华医学杂志,2015,95(36):2910-2913.
[10]王健富,刘东,吴家清,等.低位显微外科与腹腔镜精索静脉结扎术对精索静脉曲张性不育的疗效对比[J].中国医学创新,2018,15(5):34-37.