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目的：观察精索静脉高位结扎术对精索静脉曲张（VC）合并勃起功能障碍（ED）的临床效果。方法回顾性分析326例VC患者中合并ED者完整的临床资料，所有患者均手术治疗，比较术前和术后6个月国际勃起功能指数-5（IIEF-5）评分、血清卵泡刺激素（FSH）、黄体生成素（LH）、睾酮（T）和泌乳素（PRL）、患者性生活日记（SEP）等的变化。结果手术后患者IIEF-5、T、SEP等观察指标随VC术后治愈而升高，FSH、LH和PRL下降，VC疗效满意，合并的ED病情好转。结论精索静脉高位结扎术治疗VC合并ED效果明显，VC很可能是ED的危险因素，推测VC有可能是通过缺氧、氧化应激、炎症反应损伤血管内皮功能、性激素、心理因素等的机制抑制阴茎勃起功能。“,”Objective To observe the clinical effect of high ligation of spermatic vein on treatment of varicocele associated with erectile dysfunction. Methods Clinical data of 326 cases of primary varicocele patients with erectile dysfunction were retrospectively analyzed. All patients were treated with operation. International index of erectile function-5 (IIEF-5) score, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and prolactin (PRL), diary of sex life (SEP) and other changes of patients before operation and at 6th month after operation were comparatively evaluated. Results After operation, as patients with primary varicocele were cured gradually, levels of IIEF-5, T, SEP were increased, but levels of FSH, LH and PRL were decreased.The treated patients with primary varicocele combined with erectile dysfunction condition received a satisfied effect. Conclusion High ligation of spermatic vein shows obvious effect for treatment of varicocele with erectile dysfunction, and primary varicocele may be a risk factor for erectile dysfunction, may be the inhibition of penile erectile function through hypoxia, oxidative stress, inflammation to injury vascular endothelial function, sexual hormone, and psychological factors.