论文部分内容阅读
目的探讨睾丸微石症(testicular microlithiasis,TM)合并精索静脉曲张患者睾丸动脉、精索静脉的超声血流动力学水平变化,分析TM分型与精索静脉曲张分级的关系。方法 TM合并精索静脉曲张患者56例为观察组,无阴囊内疾病健康者20例为对照组,2组均行超声检查测定睾丸动脉收缩期流速(maximum velocity,Vmax)、舒张期流速(minimum velocity,Vmin)、搏动指数(pulsatility index,PI)、阻力指数(resistant index,RI)、左侧精索静脉平静呼吸时最大内径(spermatic vein diameter at rest,DR),Valsalva试验最大内径(diameter at Valsalva maneuver,DV)、精索静脉最高流速(spermatic vein maximum velocity,VS-Vmax)和静脉返流时间(venous reflux time,TR),采集精液测定精子密度、精子成活率、a级及b级精子活动率,并进行比较;分析睾丸微石症分型与精索静脉曲张分级的关系。结果 (1)观察组睾丸动脉Vmax、Vmin、RI、PI与对照组比较差异均无统计学意义(P>0.05);观察组精索静脉DR[(2.86±0.31)mm]、DV[(2.98±0.26)mm]较对照组[DR(1.30±0.21)mm、DV(1.42±0.16)mm]宽,VS-Vmax[(8.43±3.27)cm/s]较对照组[(1.15±0.34)cm/s]快,TR[(3.68±1.39)s]较对照组[(0.30±0.12)s]长(P<0.05);(2)观察组精子密度、精子成活率、a、b级精子活动率均低于对照组(P<0.05);(3)限制型TM患者中亚临床型精索静脉曲张、临床Ⅰ级发生率(27.8%、44.4%)高于经典型TM患者(18.4%、28.9%)(P<0.05),临床Ⅱ级、Ⅲ级发生率(22.2%、5.6%)低于经典型TM患者(31.6%、21.1%)(P<0.05)。结论 TM合并精索静脉曲张患者精液质量下降,精索静脉血流速度和反流时间增高,经典型睾丸微石症患者更易合并精索静脉曲张。
Objective To investigate the changes of ultrasonographic hemodynamics of testis and varicocele in patients with testicular microlithiasis (TM) and varicocele, and to analyze the relationship between TM typing and varicocele classification. Methods Fifty-six patients with varicocele were enrolled in the study, and 20 healthy people without scrotum were selected as the control group. The maximum velocity (Vmax), diastolic velocity Vmin, Vmin, pulsatility index (PI), resistance index (RI), spermatic vein diameter at rest (DR) and diameter at Valsalva test Valsalva maneuver (DV), spermatic vein maximum velocity (VS-Vmax) and venous reflux time (TR) were collected. The sperm density, sperm survival rate, sperm grade a and b Activity rate, and compared; analysis of testicular microlithiasis classification and varicocele classification relationship. Results There was no significant difference in Vmax, Vmin, RI and PI between the observation group and the control group (P> 0.05). In the observation group, DR [(2.86 ± 0.31) mm] ± 0.26) mm] was significantly larger than that of the control group [(1.30 ± 0.21) mm, DV (1.42 ± 0.16) mm] and VS-Vmax [(8.43 ± 3.27) cm / (P <0.05); (2) The density of sperm, the survival rate of sperm, the activity of a, b grade spermatozoa in observation group were significantly higher than that in control group [(0.30 ± 0.12) s] (3) In subclinical varicocele patients with limited TM, the incidence of clinical grade Ⅰ (27.8%, 44.4%) was higher than that of classic TM patients (18.4%, P <0.05) 28.9%) (P <0.05). The incidences of grade Ⅱ and Ⅲ in clinical stage (22.2%, 5.6%) were lower than those in classic TM patients (31.6% and 21.1%, P <0.05). Conclusion The sperm quality of patients with TM combined with varicocele decreased, and the spermatic vein blood flow velocity and reflux time increased. Patients with classic testicular microlithiasis were more likely to have varicocele.