《精索静脉曲张(传)》.pptVIP

精索静脉曲张(传);; 定义及分类 精索静脉曲张是指精索内蔓状静脉丛的异常伸长、扩张和迂曲。临床上可分为：原发性精索静脉曲张、亚临床型精索静脉曲张、继发性精索静脉曲张三类。 ; 流行病学 约占成年男性人群的10％－15％， 精液异常男性人群发病率25%， 不育症男性人群发病率40%。 ; 病理生理改变 静脉压力升高导致睾丸灌注不足 阴囊局部温度升高 肾源性毒性物质返流 局部代谢物质聚集; 临床表现及危害 睾丸生长发育停滞 ???囊及会阴部疼痛或不适 精液质量下降及男性不育 睾丸Leydig细胞功能衰退; 精索静脉曲张的治疗方式 观察随访 药物治疗 介入栓塞治疗 手术治疗; 手术治疗精索静脉曲张的效果评价;22 prospective studies，The random effect model was used (heterogeneity χ2?=?1210.92 [df?=?21]; p 0.0001) ;percent sperm motility in 17 studies，The random effect model was used (heterogeneity χ2?=?4308.19 [df?=?16]; p 0.0001) ; progressive sperm motility in five studies ，The random effect model was used (heterogeneity χ2?=?16.23 [df?=?4]; p?=?0.003) ;an increase in antioxidant capacity ,a decrease in oxidative stress, A reduction in sperm DNA oxidative damage;a significant improvement in postoperative semenparameters and DFI; 精索静脉曲张的手术治疗方式 经腹股沟精索静脉高位结扎术 经腹膜后精索静脉高位结扎术 腹腔镜下精索静脉高位结扎术 显微镜下精索静脉结扎术; 传统的开放手术 经腹股沟精索静脉高位结扎术 经腹膜后精索静脉高位结扎术;腹腔镜下精索静脉高位结扎术;显微镜下精索静脉结扎术 ; ; 常用手术方式的效果评价;Postoperative spontaneous pregnancy rates among different techniques;Postoperative recurrence and hydrocele formation rates among different techniques; In conclusion, Open microsurgical inguinal or subinguinal varicocelectomy techniques have been shown to result in higher spontaneous pregnancy rates and fewer recurrenc