邹峰

【摘要】 目的：探讨腹腔镜不同手术方式在精索静脉曲张中的临床治疗效果。方法：对2013年1月-2014年12月本院收治的100例采用腹腔镜手术治疗的精索静脉曲张患者资料进行分析，根据腹腔镜手术方法的不同将患者分为对照组和试验组，每组50例。对照组术中保留精索内动脉，试验组术中对精索连同动脉集束结扎，比较两组患者的疗效。结果：两组患者的住院费用比较差异无统计学意义（P>0.05）。试验组的手术时间和术后住院时间分别为（37.03±17.20）min、（3.37±2.19）d，均明显短于对照组的（47.56±23.38）min、（5.86±2.03）d，差异均有统计学意义（P<0.05）。试验组患者术前精子质量提高≥20%的比例48.0%（24/50）明显高于对照组的26.0%（13/40），术后并发症发生率4.0%明显低于对照组的20.0%，差异均有统计学意义（P<0.05）。结论：精索静脉曲张患者在腹腔镜下行精索连同动脉集束结扎治疗效果理想，手术对患者损伤小、疗效显著，复发率及并发症发生率低，值得推广使用。

【关键词】 腹腔镜不同手术方式； 精索静脉曲张； 治疗效果

Surgical Treatment Options of Varicocele/ZOU Feng.//Medical Innovation of China，2016，13（09）：129-132

【Abstract】 Objective：To investigate the clinical effect of laparoscopic surgery in different ways on varicocele.Method：The data of 100 patients with varicocele who underwent laparoscopic surgery admitted to our hospital from January 2013 to December 2014 were analyzed，they were divided into the control group and the experimental group according to the difference of laparoscopic surgical ways，50 cases in each group.The internal spermatic arteries of patients in the control group were retained，while for the patients of the experiment group，the spermatic cord were cluster ligation together with the internal artery in the surgery.The treatment effect were compared between the two groups.Result：There was no significant difference in the cost of hospitalization between the two groups（P>0.05）.The operative time and postoperative hospital stay of the experimental group were （37.03±17.20）min，（3.37±2.19）d respectively，which were significantly shorter than （47.56±23.38）min and（5.86±2.03）d of the control group，the differences were statistically significant（P<0.05）.The proportion of preoperative sperm quality increased more than 20% in the experimental group was 48.0%（24/50），which was significantly higher than 26.0%（13/40） in the control group，the postoperative complication rate of the experimental group was 4.0%，which was significantly lower than 20.0% of the control group，the differences were statistically significant（P<0.05）.Conclusion：Cluster ligation of spermatic artery together with spermatic cord in the laparoscopic surgery for patients with varicocele has significant treatment effect，low recurrence rate and complication rate，damages slightly，it is worth to be popularized.

【Key words】 Laparoscopic surgery in different ways； Varicocele； Treatment effect

First-authors address：The First Peoples Hospital of Shunde District in Foshan City，Foshan 528300，China

doi：10.3969/j.issn.1674-4985.2016.09.037

精索静脉曲张（varicocele，VC）是临床上常见的疾病，此种疾病发病率较高，且随着人们生活节奏的加快其发病率出现上升趋势。它是指精索静脉回流受到阻塞、血液反流等从而引起局部血液瘀滞，导致患者静脉丛出现扩张、伸长现象。患者发病后主要表现为阴囊肿大、坠胀感等，影响患者的正常工作和生活[1]。常规治疗方法主要以精索静脉结扎法为主，这种方法虽然能够改善患者症状，但是长期疗效欠佳，治疗预后较差。近年来，腹腔镜在精索静脉曲张患者的治疗中广为使用，并取得了理想疗效，但是临床上对于腹腔镜不同手术方式尚存在较大的争议[2]。为了探讨腹腔镜不同手术方式在精索静脉曲张中的临床治疗效果，本文将100例精索静脉曲张患者进行分组后分别采用不同的手术方法进行治疗，现将具体结果报告如下。