腹腔镜单双侧精索内外静脉同时结扎对精索静脉曲张患者血清生殖激素及睾丸生精功能影响.docVIP

腹腔镜单双侧精索内外静脉同时结扎对精索静脉曲张患者血清生殖激素及睾丸生精功能影响 　　[摘要] 目的 观察腹腔镜单、双侧精索内、外静脉同时结扎对精索静脉曲张患者血清生殖激素及睾丸生精功能的影响。 方法 选择2010年1月～2014年11月本院收治的67例双侧精索静脉曲张（右侧亚临床型）患者，将其随机分为单侧组（35例）与双侧组（32例），单侧组行单侧精索静脉结扎，双侧组行双侧精索静脉结扎，观察两组血清卵泡刺激素（FSH）和黄体生成素（LH）、睾丸生精功能术前、术后的变化及临床症状的改变。 结果 两组血清FSH和LH术后较术前均明显降低（P0.05）；两组精液中精子密度、精子活率、精子活动力a级+b级所占比例术后较术前均明显升高（P0.05）。两组患者术后都临床症状均明显改善，且并发症少、轻，复发率低。 结论 双侧精索静脉曲张患者（右侧亚临床型）腹腔镜精索内、外静脉同时结扎治疗能显著降低血清FSH和LH水平，改善睾丸生精功能，消除临床症状，但双侧结扎并没有比单侧结扎有更大的优势。 　　[关键词] 精索静脉曲张；生殖激素；生精功能；结扎 　　[中图分类号] R588.1 [文献标识码] A [文章编号] 1674-4721（2015）09（a）-0060-04 　　[Abstract] Objective To observe the effect of serum reproductive hormone and testis spermatogenesis on varicocele patients by unilateral or bilateral laparoscopic simultaneous ligation of internal and exteral spermatic veins. Methods 67 patients with two sided varicocele all have a sub-clinical varicocele on the right side in our hospital from January 2010 to November 2014 were selected and divided into unilateral group（35 cases） and bilateral group（32 cases） in random.The unilateral group was operated unilateral ligation of spermatic vein in the unilateral group， bilateral group was operated bilateral ligation of spermatic vein in the bilateral group.Serum follicle stimulating hormone（FSH） level and luteinizing hormone（LH） level and testis spermatogenesis in two groupswas compared，and the change of clinical symptoms was also observed. Results The serum levels of FSH and LH in two groups were significantly reduced at post-surgery than that at pre-surgery （P0.05）.The sperm concentration，sperm motility and sperm vitality（class a+class b） in two groups were significantly increased at post-surgery than that at pre-surgery （P0.05）.The clinical symptoms in two groups were much relieved after surgery，and operation complications were few and no severe，and low recurrence rate. Conclusion Unilateral or bilateral laparoscopic simultaneous ligation of internal and exteral spermatic veins in patients with two sided varicocele all have a sub-clin