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目的探讨腹腔镜精索静脉高位结扎术对精索静脉曲张(VC)患者术后精液质量及康复进程的影响。方法选取2015年2月—2017年2月河南省军区医院收治的104例VC患者,根据手术方案分组,各52例。对照组予以开放手术,研究组予以腹腔镜精索静脉高位结扎术。统计对比两组精液质量(精子存活率、精子密度、精子畸形率)、围手术期指标(手术时间、胃肠功能恢复时间、住院时间、住院费用)变化情况、并发症发生情况(睾丸鞘膜积液、阴囊水肿)、术后复发率及配偶妊娠率。结果研究组住院时间、胃肠功能恢复时间、手术时间、住院费用均低于对照组,差异有统计学意义(P<0.05);术后两组精液质量均较术前改善,研究组精子存活率、精子密度高于对照组,精子畸形率低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率、复发率(3.84%、3.84%)低于对照组(23.07%、19.23%),配偶妊娠率(61.53%)高于对照组(42.30%),差异有统计学意义(P<0.05)。结论腹腔镜精索静脉高位结扎术可提高VC患者术后精液质量,缩短住院时间、手术时间、胃肠功能恢复时间,减少住院费用,降低并发症发生率、复发率,提高配偶妊娠率。
Objective To investigate the effects of laparoscopic high varicocele ligation on postoperative sperm quality and recovery of varicocele (VC) patients. Methods A total of 104 patients with VC who were admitted to Henan Provincial Military Hospital from February 2015 to February 2017 were selected and divided into two groups according to the operation plan. The control group was open surgery, the study group was laparoscopic varicocele ligation. The changes of semen quality (sperm survival rate, sperm density, sperm deformity rate), perioperative indexes (operation time, gastrointestinal function recovery time, hospitalization time and hospitalization expenses) and complications were compared between the two groups Effusion, scrotal edema), postoperative recurrence and spouse pregnancy rate. Results The hospitalization time, the recovery time of gastrointestinal function, the operation time and the cost of hospitalization were all lower in the study group than in the control group (P <0.05). The sperm quality of the two groups were improved compared with that before operation. The sperm survival Sperm densities were higher in the control group than those in the control group (P <0.05). The incidence of complications and the recurrence rate (3.84%, 3.84%) in the study group were lower than those in the control group %, 19.23%). The pregnancy rate of the spouses was 61.53% higher than that of the control group (42.30%). The difference was statistically significant (P <0.05). Conclusion High ligation of laparoscopic varicocele can improve postoperative sperm quality, shorten the hospitalization time, operation time, gastrointestinal function recovery time, reduce the cost of hospitalization, reduce the complication rate, recurrence rate and improve the pregnancy rate of VC patients.