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目的:探讨显微外科技术治疗青年男性精索静脉曲张的临床疗效。方法:收集并分析2012~2015年底32例运用显微外科技术治疗青年男性精索静脉曲张的临床资料以及术后随访情况,观察术后精液质量、症状改善情况以及并发症。结果:32例患者手术成功,获得随访3~12个月的患者29例(90.62%),失访3例(9.38%),其中不育患者失访1例,睾丸坠胀不适、疼痛等症状就诊者失访2例。术前主要以睾丸坠胀不适、疼痛等症状获得随访的11例患者,术后症状消失者8例(72.72%),减轻2例(18.18%),无改善1例(9.09%)。获得随访的18例不育或少弱精子症者术后6个月精子浓度及活力较术前显著改善。29例获访患者中术后发生阴囊水肿1例(3.44%),经保守治疗症状改善,无睾丸鞘膜积液、睾丸萎缩、急性附睾炎及术后复发等情况发生。结论:显微外科技术在治疗青年精索静脉曲张,可有效改善阴囊坠胀、疼痛等局部不适症状,并在一定程度上提高精液参数,逐渐成为治疗精索静脉曲张的理想手段。
Objective: To investigate the clinical effect of microsurgery on young varicocele in men. Methods: The clinical data of 32 cases of varicocele treated by microsurgical techniques from 2012 to 2015 were collected and analyzed. The postoperative follow-up and postoperative semen quality, symptom improvement and complication were observed and analyzed. Results: Thirty-two patients were successfully surgically treated. Among them, 29 patients (90.62%) were followed up for 3 to 12 months, 3 patients (9.38%) lost to follow-up, 1 patient lost to sterility, Visitors lost two cases. Eleven patients were followed up preoperatively with symptom such as testicular bulge discomfort and pain. There were 8 patients (72.72%) with symptom disappeared, 2 patients (18.18%) relieved, and 1 patient without improvement (9.09%). Eighteen cases of infertility or oligospermia who were followed up showed a significant improvement of sperm concentration and vitality at 6 months after operation. Among the 29 patients, 1 case (3.44%) had scrotal edema after operation. The symptoms of conservative treatment, no testicular hydrocele, testicular atrophy, acute epididymitis and postoperative recurrence occurred. CONCLUSIONS: Microsurgery is a good way to treat varicocele in young patients. It can effectively improve the partial discomfort of the scrotum such as bulge and pain and improve the semen parameters to a certain extent.