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Title: [Microscopic spermatic vein ligation for the treatment of varicocele].
Author: Feng Q, Qiu MX.
Journal: Zhonghua Nan Ke Xue; 2017 Dec; 23(12):1080-1084. PubMed ID: 29738177.
Abstract:
OBJECTIVE: To explore the effect of spermatic vein ligation under the microscope in the treatment of varicocele (VC). METHODS: A total of 120 VC patients received in our department from September 2011 to February 2015 were randomly divided into an experimental and a control group of equal number, the former treated by microscopic spermatic vein ligation and the latter by conventional open high ligation. Comparisons were made between the two groups of patients in the internal diameters of the spermatic vein during eupnea and Valsalva maneuver, the reflux time of the spermatic vein, blood flow parameters of the testicular artery, and semen quality before and at 3 months after surgery. RESULTS: At 3 months after surgery, the experimental group, as compared with the control, showed significantly decreased reflux time of the spermatic vein (［0.41 ± 0.10］ vs ［1.08 ± 0.10］ s, P <0.05) and peak systolic velocity (9.26 ± 1.35 vs 10.64 ± 1.28, P <0.05) and resistance index (0.52 ± 0.03 vs 0.61 ± 0.03, P <0.05) of the testicular artery but markedly increased internal diameters of the spermatic vein during eupnea (［1.63 ± 0.07］ vs ［1.59 ± 0.06］ mm, P <0.05) and Valsalva maneuver (［1.72 ± 0.05］ vs ［1.68 ± 0.07］ mm, P <0.05), sperm concentration (［46.84 ± 5.24］ vs ［35.35 ± 4.26］ ×10⁶/ml, P <0.05), sperm motility (［63.75 ± 7.73］ vs ［53.87 ± 6.46］ %, P <0.05), and total sperm count (［89.54 ± 7.95］ vs ［75.24 ± 8.43］ ×10⁶/ml, P <0.05). CONCLUSIONS: Microscopic spermatic vein ligation has a definite effect in the treatment of varicocele, which can significantly improve the testicular blood flow and semen quality of the patient. 目的：探讨显微镜下精索静脉结扎术对精索静脉曲张患者的治疗效果。方法：选择2011年9月至2015年2月来我院进行治疗的精索静脉曲张患者120例，随机分为试验组和对照组，各60例。试验组行显微镜下精索静脉结扎术，对照组患者行传统开放高位结扎术。对比手术前后两组患者平静呼吸和作Valsalva 动作后精索静脉内径、精索静脉返流时间、睾丸包膜动脉血流数值和精液质量。结果：组间比较显示，术后3个月试验组患者精索静脉返流时间显著短于对照组患者［（0.41±0.1) s vs (1.08±0.1) s，P<0.05］，术后3个月试验组患者精索静脉最大内径在静息、Valsalva动作状态下均超过对照组［（1.63±0.07) mm vs (1.59±0.06) mm，(1.72±0.05) mm vs (1.68±0.07) mm，P均<0.05］；术后3个月试验组患者睾丸包膜动脉收缩期最大流速（PSV）（9.26±1.35 vs 10.64±1.28，P<0.05）、血管阻力指数（RI）（0.52±0.03 vs 0.61±0.03，P<0.05)均较对照组明显减少；术后3个月试验组患者精子浓度［（46.84±5.24）×10⁶/ml vs （35.35±4.26）×10⁶/ml，P<0.05］、精子活率［（63.75±7.73）% vs （53.87±6.46）%，P<0.05］及总精子计数［（89.54±7.95）×10⁶/ml vs （75.24±8.43）×10⁶/ml，P<0.05）］均高于对照组。结论：本研究结果显示，显微镜下精索静脉结扎术疗效确切，可以有效改善睾丸血流，提高精液质量，值得临床推广。.

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