高选择性微创治疗精索静脉曲张的疗效及对其相关血清指标的影响

doi:10.3969/j.issn.10056483.2019.02.011

摘要/Abstract

摘要： 目的：探讨高选择性微创治疗精索静脉曲张的疗效及对其相关血清指标的影响。方法：精索静脉曲张病人120例，根据手术手术方式的不同，分为研究组和对照组两组，每组各60例，研究组采用腹腔镜精索静脉高选择结扎术，对照组采用腹腔镜下精索血管集束结扎术。比较两组病人临床疗效的差异。结果：研究组病人术后的症状改善率（95.0%）高于对照组（80.0%）（P＜0.05）；术前两组病人的血清免疫相关指标IgG、IgA和IgM比较均无差异（P＞0.05）。术后研究组病人的血清免疫指标IgG、IgA和IgM分别为（16.8±2.2）g/L、（2128.2±583.0）mg/L和（2518.4±412.2）mg/L，对照组分别为（11.5±1.8 ）g/L、（1643.9±421.5 ）mg/L和（1711.7±336.8） mg/L，两组比较差异有统计学意义（P＜0.05）；术前两组病人的血清生殖激素相关指标T、LH、FSH比较均无差异（P＞0.05）。术后研究组病人的血清生殖激素指标T、LH和FSH分别为（1.90±0.27 ）ng/ml、（2.42±0.50） mIU/m和（1.45±0.12） mIU/ml，对照组分别为（1.78±0.24 ）ng/ml、（2.84±0.51） mIU/ml和（1.67±0.13） mIU/ml，两组比较差异有统计学意义（P＜0.05）；术前两组病人精子浓度、精子活力和精子畸形率比较差异无统计学意义（P＞0.05），而术后研究组病人的精子浓度为（53.20±7.46）×106/ml，精子活力为（72.62±9.52）%；精子畸形率为（14.35±5.14）%，对照组分别为（44.58±7.54）×106/ml、（62.86±8.53）%和（19.66±6.29）%，差异有统计学意义（P＜0.05）。结论：高选择性腹腔镜下精索静脉结扎术治疗精索静脉曲张的疗效更为显著，同时可提高病人免疫力并改善不育状况。

关键词: 腹腔镜下高选择性精索静脉高位结扎术, 精索静脉曲张, 免疫力, 生殖激素, 精子质量

Abstract: Objective：To investigate the effect of highly selective minimally invasive treatment of varicocele and its effect on serum indexes.Methods：To screening 120 cases of the patients with varicocele as research subjects，which were divided into study group with 60 cases and control group with 60 cases，patients in control group were given laparoscopic cluster spermatic vein ligation and patients in study group were given laparoscopic highselectivity spermatic vein ligation，then the two groups were compared in terms of clinical efficacy and so on.Results：The clinical efficiency in study group（95.0%） was higher than the control group（80.0%）（P<0.05）；There were no significance in immune indexes（P＞0.05）.The immune indexes of IgG，IgA and IgM in study group were （16.8±2.2）g/L，（2128.2±583.0）mg/L，（2518.4±412.2）mg/L，respectively；while in control group were （11.5±1.8）g/L，（1643.9±421.5）mg/L，（1711.7±336.8）mg/L，respectively.The difference between the two groups was statistically significant（P＜0.05）.There was no difference in serum reproductive hormone T，LH and FSH between the two groups（P＞0.05）.The reproductive hormone indexes of T，LH and FSH after surgery in study group were（1.90±0.27 ）ng/ml，（2.42±0.50） mIU/m，（1.45±0.12） mIU/ml，respectively；while in control group were（1.78±0.24 ）ng/ml，（2.84±0.51） mIU/ml，（1.67±0.13） mIU/ml，respectively（P＜0.05）.There was no significant difference in sperm concentration，sperm motility and sperm malformation rate between the two groups（P＞0.05）.Postoperative sperm concentration in the study group was（53.20±7.46）×106/ml，the sperm activity was （72.62±9.52）%，the rate of sperm malformation was （14.35±5.14）%，while in control group were（44.58±7.54）×106/ml，（62.86±8.53）%，（19.66±6.29）%，respectively（P＜0.05）.Conclusion：The laparoscopic highselectivity spermatic vein ligation in the treatment of the patients with varicocele is significant，it is worthy of popular〖LM〗ization and application.

Key words: laparoscopic highselectivity spermatic vein ligation, varicocele, immune function, reproductive hormone, semen quality

孟军, 周青, 陈耀武. 高选择性微创治疗精索静脉曲张的疗效及对其相关血清指标的影响[J]. 临床外科杂志, 2019, 27(2): 121-124.

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