腹腔镜高位结扎与经腹股沟途径高位结扎治疗精索静脉曲张的临床疗效探讨

摘要

Objective To analyze the feasibility and validity of laparoscopic high ligation in the treatment of varicocele and its superiority over traditional surgery. Methods A retrospectively analysis was done on 298 male patients with varicocele-induced infertility who were admitted and confirmed in this hospital between October 2010 and December 2013. They were randomized to underwent laparoscopic high ligation (the laparoscopic group, n=158) and conventional high ligation through inguinal approach (the conventional group, n=140). The clinical efficacy was observed, and the validity and complications were compared between the two procedures. Results There were statistically significant differences in operative duration, intraop-erative blood loss, length of hospital stay between the two groups, t=16.56, 125.92, 9.78 respectively, P<0.01. In terms of validity, the laparoscopic group was higher than the conventional group, and the difference was statistically significant (χ2=6.75, P<0.01); in terms of semen parameters, the laparoscopic group was superior to the conventional group, and the difference was statistically significant (χ2=6.08, P<0.01);in terms of complication rates, the conventional group was higher than the la-paroscopic group, and the difference was statistically significant (χ2=9.98, P<0.01). Conclusion Compared with conventional high ligation through inguinal approach, laparoscopic high ligation in the treatment of varicocele has the advantages of shorter operative duration, , fewer complications, high cure rate, quicker recovery, , small trauma. This safe and reliable operation method can be used as the preferred one.%目的：分析腹腔镜精索静脉高位结扎术治疗静脉曲张的可行性、有效性以及较传统手术的优越性。方法回顾分析整群选取2010年10月—2013年12月期间，该院收治的患男性不育及确诊为精索静脉曲张的病人298例，按单纯随机抽样的方法分为两组，腹腔镜组病人158例，给予经腹腔镜下精索静脉高位结扎术；传统手术组病人140例给予传统的经腹股沟途径精索静脉高位结扎术，观察临床疗效，并分析对比两种方法的有效性及并发症发生状况。结果两组手术时间、术中出血量、住院时间差异有统计学意义（t值分别为16.56、125.92、9.78，P＜0.01）；术后有效性：腹腔镜组优于传统手术组，差异有统计学意义（χ2=6.75,P＜0.01）；精液参数比较：腹腔镜组优于传统手术组，差异有统计意义（χ2＝6.08，P＜0.01）；并发症发生率：传统组较腹腔镜组发生率高，差异有统计学意义（χ2＝9.98，P＜0.01）。结论腹腔镜下精索静脉曲张高位结扎术，较传统腹股沟入路手术具有手术时间短，治愈率高，术后恢复快，对机体创伤小，并发症少等优点，是一种安全可靠的手术方法，可作为治疗精索静脉曲张的首选方法。