孙伟

[摘要] 目的 研究精索靜脉曲张患者运用腹腔镜手术和腹膜后开放手术治疗方式具有的效果及存在的优缺点。 方法 便利选择该医院的患者参与实验的方式验证疗效，患者来自于2017年1月—2019年1月的100例精索静脉曲张患者，随机数字化将100例患者根据治疗方式分成腹腔镜组与腹膜开放组，各50例，腹腔镜组给予腹腔镜手术治疗方式，腹膜开放组给予腹膜后开放手术治疗方式。观察并准确记录两组患者的治疗有效率、手术时间、术中出血量、住院时间，比较两组数据。 结果 通过治疗后，腹腔镜组治疗总有效率为96.00%。腹膜开放组治疗总有效率为86.00%，腹腔镜组患者的治疗有效率显著优于腹膜开放组患者（χ2=5.621，P<0.05）。腹腔镜组患者平均手术时间为（34.82±3.15）min;术中平均出血量为（31.28±15.34）mL，平均住院时间为（4.85±1.28）d。腹膜开放组患者在手术平均时间为（45.14±2.89）min;术中平均出血量为（61.28±11.29）mL，平均住院时间为（9.14±1.05）d。从上述的各项指标可以看出，腹腔镜组患者的各项指标显著优于腹膜开放组患者，两组数据差异有统计学的意义（P<0.05）。结论 采用腹腔镜手术治疗方式具有的效果良好，且创伤度较小，患者恢复效率较快。

[关键词] 精索静脉曲张;腹腔镜手术;腹膜后开放手术;疗效

[Abstract] Objective To study the effects and advantages and disadvantages of laparoscopic and retroperitoneal open surgery in patients with varicocele. Methods Patients of the author's hospital were selected to participate in the experiment to verify the efficacy. The patients were from 100 patients with varicocele from January 2017 to January 2019. Randomly digitized 100 patients were divided into laparoscopic group and open peritoneal group according to the treatment method In each of the 50 cases， the laparoscopic group was given a laparoscopic surgical treatment， and the open peritoneal group was given a retroperitoneal open surgical treatment. Observe and accurately record the treatment efficiency， operation time， intraoperative blood loss， and hospital stay of the two groups of patients， and compare the two groups of data. Results After treatment， the total effective rate in the laparoscopic group was 96.00%. The total effective rate of the open peritoneal group was 86.00%. The treatment efficiency of the patients in the laparoscopic group was significantly better than that in the open peritoneal group（χ2=5.621， P<0.05）. The average operation time of patients in the laparoscopic group was （34.82±3.15） min; the average blood loss during the operation was （31.28±15.34） mL， and the average hospital stay was （4.85±1.28）d. The average operative time in the open peritoneum group was （45.14±2.89） min; the average intraoperative blood loss was （61.28±11.29） mL， and the average hospital stay was （9.14±1.05）d. From the above indicators， it can be seen that the indicators of patients in the laparoscopic group were significantly better than those in the open peritoneal group， and the data of the two groups were statistically significant（P<0.05）. Conclusion Laparoscopic surgery has a good effect， has less trauma， and has a faster recovery rate.

[Key words] Varicocele; Laparoscopic surgery; Retroperitoneal open surgery; Efficacy

精索静脉曲张（VC）属于血管病变范畴，是患者体内的精索内蔓状静脉丛发生了异常性的扩张、伸长、迂曲。患者患有此病症后的临床表现具有疼痛、进行性睾丸功能减退的现象，是泌尿外科临床治疗中的常见性疾病。精索静脉曲张病症大多数会发生于青壮年时期的男性患者中，属于常见性疾病[1]。此病症严重影响着患者的身心健康，需要采用疗效较好的治疗措施给予治疗。以往采取的治疗方式为腹膜后开放式手术治疗方式，属于高位结扎性的手术[2-3]。从治疗效果来看，治疗有效率较好。医疗的不断发展诞生了腹腔镜技术，在治疗精索静脉曲张病症中，采用了腹腔镜手术治疗方式，具有的效果良好。……