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目的探讨两种手术治疗对精索静脉曲张患者血清免疫球蛋白浓度及预后的不同影响,为精索静脉曲张治疗方法的选择提供依据。方法将88例原发性精索静脉曲张患者根据手术方法分为显微镜组(n=44)和腹腔镜组(n=44)。比较两组疗效、手术时间、术后住院时间、围术期血清免疫球蛋白浓度、并发症发生及术后12个月的复发情况。结果显微镜组手术时间为(54.69±8.59)min,长于腹腔镜组的(35.97±7.15)min,差异有统计学意义(P<0.05)。与腹腔镜组比较,显微镜组T_2和T_3的血清免疫球蛋白浓度升高,差异有统计学意义(P<0.05)。显微镜组并发症总发生率和术后12个月复发率分别为2.27%和2.27%,均低于腹腔镜组的20.45%和18.18%(P<0.05)。结论显微镜下行精索静脉高位结扎术治疗精索静脉曲张可更有效提高患者免疫功能和改善其预后,可行性和安全性较高,值得临床推广使用。
Objective To investigate the different effects of two surgical treatments on serum immunoglobulin concentration and prognosis in patients with varicocele, and to provide evidence for the selection of varicocele treatment. Methods Eighty-eight patients with primary varicocele were divided into microscopy group (n = 44) and laparoscopic group (n = 44) according to the surgical method. The curative effect, operation time, postoperative hospital stay, perioperative serum immunoglobulin concentration, complications and recurrence after 12 months were compared between the two groups. Results The operation time of the microscope group was (54.69 ± 8.59) min, which was longer than that of the laparoscopic group (35.97 ± 7.15) min, the difference was statistically significant (P <0.05). Compared with the laparoscopic group, the serum immunoglobulin concentrations of T 2 and T 3 in the microscope group were significantly increased (P <0.05). The total complication rate of microscopy and the recurrence rate at 12 months after surgery were 2.27% and 2.27%, respectively, which were lower than those of laparoscopic group (20.45% vs 18.18%, P <0.05). Conclusion Microsurgical high varicocele ligation of the varicocele can be more effective in improving immune function and improve prognosis in patients with high feasibility and safety, worthy of clinical promotion and use.