張經(jīng)濤
[摘要] 目的 研究腹腔鏡手術精索靜脈曲張治療后的生育能力恢復。方法 隨機選取2014年8月—2016年8月淄博市計劃生育技術指導中心男性科收治的精索靜脈曲張患者60例,采用SPSS 21.0將入組患者按先后序列號(1~60)隨機分為2組:一組腹腔鏡精索靜脈高位結扎術治療組(腹腔鏡手術組,30例),一組開腹腹膜后精索靜脈高位結扎術治療組(開腹手術組,30例),統(tǒng)計分析兩組患者的精子密度、活動率、畸形率、手術時間、術后腸功能恢復時間、住院時間、術后并發(fā)癥發(fā)生情況。 結果? 腹腔鏡手術組患者的精子密度、活動率(26.4±3.6)×106/mL、(55.7±3.3)%均顯著高于開腹手術組(18.8±2.7)×106/mL、(32.0±4.2)%(t=6.965,4.541,P<0.05),畸形率(64.1±4.3)%顯著低于開腹手術組(80.2±6.1)%(t=4.365,P<0.05)。腹腔鏡手術組患者的雙側(cè)手術時間、住院時間(40.4±10.1)min、(3.1±1.0)d均顯著短于開腹手術組(63.3±15.2)min、(7.2±2.4)d(t=4.303,4.182,P<0.05),但兩組患者的單側(cè)手術時間、術后腸功能恢復時間(36.6±8.8)min、(18.5±4.6)h vs(39.4±10.6)min、(15.1±3.5)h之間的差異無統(tǒng)計學意義(t=1.886,1.638,P>0.05)。腹腔鏡手術組、開腹手術組患者的術后并發(fā)癥發(fā)生,10.0%(3/30)、13.3%(4/30)之間的差異無統(tǒng)計學意義(χ2=1.32,P>0.05)。 結論 腹腔鏡手術較開腹手術精索靜脈曲張治療后更能有效恢復患者的生育能力。
[關鍵詞] 腹腔鏡手術;精索靜脈曲張;生育能力
[中圖分類號] R71? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742(2019)05(b)-0038-03
[Abstract] Objective To study the recovery of fertility after varicocele treatment in laparoscopic surgery. Methods A total of 60 patients with varicocele admitted to the male family of Zibo City Family Planning Technical Guidance Center from August 2014 to August 2016 were randomly selected. The patients were randomly assigned to the serial number (1-60) by SPSS21.0 and were divided into two groups of laparoscopic varicocele ligation group(30 cases in laparoscopic surgery group), one group of open laparoscopic varicocele ligation group(open surgery group, 30 cases). The sperm density, activity rate, deformity rate, operation time, postoperative intestinal function recovery time, hospitalization time, and postoperative complications were analyzed statistically. Results The sperm density and activity rate of patients in the laparoscopic surgery group (26.4±3.6)×106/mL and (55.7±3.3)% were significantly higher than those in the open surgery group (18.8±2.7)×106/mL, (32.0±4.2)% (t=6.965, 4.541, P<0.05), the deformity rate (64.1±4.3)% was significantly lower than that of the open surgery group (80.2±6.1)% (t=4.365, P<0.05). The bilateral operation time and hospitalization time (40.4±10.1) min and (3.1±1.0)d in the laparoscopic surgery group were significantly shorter than those in the open surgery group (63.3±15.2)min, (7.2±2.4) d (t= 4.303, 4.182, P<0.05), but the unilateral operation time and postoperative intestinal function recovery time (36.6±8.8) min, (18.5±4.6)h vs (39.4±10.6)min, (15.1±3.5)h, was not significant (t=1.886, 1.638, P>0.05). Postoperative complications occurred in the laparoscopic surgery group and the open surgery group of 10.0% (3/30) and 13.3% (4/30) was not significant (χ2=1.32, P>0.05). Conclusion Laparoscopic surgery can effectively restore the fertility of patients after laparoscopic varicocele treatment.
該研究結果表明,腹腔鏡手術組患者的精子密度、活動率(26.4±3.6)×106/mL、(55.7±3.3)%均顯著高于開腹手術組(18.8±2.7)×106/mL、(32.0±4.2)%(t=6.965,4.541,P<0.05),畸形率(64.1±4.3)%顯著低于開腹手術組(80.2±6.1)%(t=4.365,P<0.05)。腹腔鏡手術組患者的雙側(cè)手術時間、住院時間(40.4±10.1)min、(3.1±1.0)d均顯著短于開腹手術組(63.3±15.2)min、(7.2±2.4)d(t=4.303,4.182,P<0.05),但兩組患者的單側(cè)手術時間、術后腸功能恢復時間(36.6±8.8)min、(18.5±4.6)hvs(39.4±10.6)min、(15.1±3.5)h之間的差異無統(tǒng)計學意義(t=1.886,1.638,P>0.05)。腹腔鏡手術組、開腹手術組患者的術后并發(fā)癥發(fā)生,10.0%(3/30)、13.3%(4/30)之間的差異無統(tǒng)計學意義(χ2=1.32,P>0.05),和上述相關醫(yī)學研究結果一致。
綜上所述,腹腔鏡手術較開腹手術精索靜脈曲張治療后更能有效恢復患者的生育能力,值得在臨床推廣應用。
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(收稿日期:2019-02-18)