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目的比较显微镜下腹股沟管下精索静脉结扎术(subinguinal microscopic varicocelectomy,SMV)与开放经腹膜后高位结扎术(open transperitoneal ligation,OTL)治疗精索静脉曲张的疗效。方法 88例精索静脉曲张军人患者,其中46例行OTL术(OTL组),42例行SMV术(SMV组),比较2组手术前、后精液学参数,复发和并发症情况。结果 2组术后精索内静脉内径、精子计数及精子活动力均较术前明显改善(P<0.01);术后6个月,SMV组精子活动力明显高于OTL组,鞘膜积液发生率明显低于OTL组(P<0.05),2组精索内静脉内径、精子计数、复发率比较差异无统计学意义(P>0.05)。结论对Ⅱ～Ⅲ度单侧精索静脉曲张者行SMV手术,有助于提高精子活动力,减少并发症。
Objective To compare the efficacy of sublinguinal microscopic varicocelectomy (SMV) and open transperitoneal ligation (OTL) under microscope in the treatment of varicocele. Methods Eighty - eight patients with varicocele were recruited. Among them, 46 patients underwent OTL (OTL) and 42 patients underwent SMV (SMV). The preoperative and postoperative semen parameters, recurrence and complications were compared between the two groups. Results After operation, sperm inner diameter, sperm count and sperm motility were significantly improved in both groups (P <0.01). At 6 months after operation, sperm motility in SMV group was significantly higher than that in OTL group (P <0.05). There was no significant difference in the diameter, sperm count and recurrence rate between the two groups (P> 0.05). Conclusion SMV surgery for unilateral varicocele Ⅱ ~ Ⅲ degree, help to improve sperm motility, reduce complications.