腹腔镜精索静脉高位结扎术治疗精索静脉曲张临床体会.docVIP

腹腔镜精索静脉高位结扎术治疗精索静脉曲张临床体会 　　【摘要】目的：探讨腹腔镜精索静脉高位结扎术治疗精索静脉曲张的临床价值。方法：回顾性分析96例应用腹腔镜精索静脉高位结扎术治疗的精索静脉曲张患者资料。男性患者，年龄11~45岁，平均（21.3±1.08）岁，左侧72例，双侧22例，右侧2例，并随访观察。结果：96例手术均获得成功，手术时间15~40min，平均(26.2±1.51)min，基本无出血，术后平均住院(2.81±0.62)d。随访3~9个月，3例复发，复发率 3.12%，精液质量显著提高。结论：腹腔镜精索静脉高位结扎术具有手术时间短，创伤小，出血少，术后恢复快，效果好，并发症少等优点，对双侧精索静脉曲张、曾有同侧腹股沟术史和开放术后复发的患者更具有临床价值。 　　【关键词】腹腔镜 精索静脉曲张 精索静脉高位结扎术 　　 　　Laparoscopic varicocele ligation for varicocele treatment of clinical experience 　　（96 cases） 　　Liu mingJianWu BaozhongYang DikuanLin HaoshengXiao JianZhang Qifei Li Wenzhao 　　(The Second Peoples Hospital of Zhaoqing City, Zhaoqing, Guangdong 526060) 　　【Abstract】Objective：laparoscopic varicocele ligation of varicocele clinical value. Methods：Retrospective analysis of 96 cases of laparoscopic spermatic vein ligation in patients with varicocele treatment information. Male patients, aged 11 to 45 years, mean (21.3±1.08) years, left 72 patients, bilateral in 22 cases, the right side in 2 cases, and followed up. Results：96 cases were operated successfully, the operation time 15 ~ 40min, mean (26.2 ± 1.51) min, almost no bleeding, postoperative hospital stay (2.81±0.62) d. Followed up for 3 to 9 months, 3 patients had recurrence rates of 3.12%, semen quality improved significantly. Conclusion：Laparoscopic varicocele ligation with shorter operation time, trauma, less bleeding, rapid postoperative recovery, the effect is good, fewer complications, on the bilateral varicocele, had history of inguinal surgery and recurrence in patients with open more clinical value. 　　【Key word】 laparoscopicvaricoceleligation of varicocele 　　 　　目前治疗精索静脉曲张手术方法常有二种：一、传统开放性结扎术；二、腹腔镜下结扎术。自从1992年腹腔镜应用于泌尿外科以来，因其独特的优势被越来越多的应用于临床。我院自2003年1月至2010年10月采用腹腔镜精索静脉高位结扎术治疗精索静脉曲张患者96例，效果满意，现报道如下: 　　1资料与方法 　　1.1临床资料 　　本组精索静脉曲张患者96例，年龄11~45岁，平均（21.3±1.08）岁。左侧72例，占 75%，双侧22例，占 22.9%，右侧2例，占 2.1%，均为中重度，以睾丸坠胀不适就诊 59例，占61%；以不育症就诊 37例，占39%；开放术后复发6例，同侧腹股沟手术史4例。诊断依靠体格检查及彩超检查，阴囊可触及或探及曲张的血管团，站立或屏气时加重，平卧位及放松时明显减轻或消失；彩色多普勒检查示血管内径2.2~3.5mm，平均