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目的:探索经腹膜后集束结扎精索血管术治疗精索静脉曲张的疗效。方法:采用自腹股沟韧带中点上方2cm处向外上方做长约4cm平行于腹股沟韧带的切口经腹膜后结扎曲张的精索静脉,治疗原发性精索静脉曲张患者52例。对临床资料进行回顾性分析。结果:52例患者中,出院时患者阴囊索静脉曲张团基本消失,Vasalva试验阴性,均无精索肿痛、附睾炎、睾丸萎缩及精索静脉曲张。阴囊彩超示双侧睾丸血供好。有10例不育症患者,在术6个月复查精液常规,精子数及活动率明显改善。术后1年内发生左侧睾丸鞘膜积液4例,占随访人数的7.7%。获1年～5年随访,均无复发,末见睾丸、附睾萎缩。结论:该术式操作简单,疗效确定,安全易掌握,复发率低,适合在基层医院开展,值得在临床上推广应用。
OBJECTIVE: To explore the curative effect of transcervical ligation of spermatic cord in the treatment of varicocele. Methods: A total of 52 cases of primary varicocele were treated with a length of about 4 cm parallel to the incision of the inguinal ligament through the retroperitoneal ligation of the varicocele 2 cm above the midpoint of the inguinal ligament. The clinical data were retrospectively analyzed. Results: Among the 52 patients, the patients with varicocele disappeared basically and the Vasalva test was negative. There were no spermatic cord pain, epididymitis, testicular atrophy and varicocele. Scrotal ultrasound showed bilateral testicular blood supply. There are 10 cases of infertility patients, semen routine examination in 6 months, sperm count and activity rate significantly improved. Four cases of left testicular hydrocele occurred within one year after surgery, accounting for 7.7% of the follow-up. 1 year to 5 years follow-up, no recurrence, end testes, epididymal atrophy. Conclusion: The operation is simple, efficacy, safety and easy to grasp, low recurrence rate, suitable for primary hospitals, it is worth to promote the clinical application.