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目的 :探讨微型血管多普勒指引下改良显微精索静脉结扎术的安全性与有效性。方法 :回顾性分析2014年1月—2015年7月共26例精索静脉曲张患者的临床资料,平均年龄25.6岁(18~42岁)。患者均接受微型血管多普勒指引下改良显微精索静脉结扎术。术中应用血管多普勒分辨精索动、静脉,防止误扎导致动脉损伤。结果:所有手术均顺利完成,术中无精索内动脉损伤;术后随访6~24个月,18例少精弱精症患者复查精子密度及活动率有明显改善,19例患者阴囊隐痛不适症状消失、7例减轻,复查B超显示无明显阴囊血肿、睾丸萎缩或鞘膜积液发生,未见复发。结论:微型血管多普勒指引下改良显微精索静脉结扎术安全有效,避免了手术对动脉的损伤,可明显改善重度精索静脉曲张患者的症状和精子质量,疗效确切,具有推广价值。
Objective: To investigate the safety and effectiveness of modified micro-varicocele ligation guided by micro-vascular Doppler. Methods: The clinical data of 26 patients with varicocele from January 2014 to July 2015 were retrospectively analyzed. The mean age was 25.6 years (18-42 years). Patients underwent modified micro-spermatic vein ligation guided by microvascular Doppler. Intraoperative vascular Doppler differential sperm motility, veins, prevent misdiagnosis caused by arterial injury. Results: All the operations were successfully completed without intra-arterial spermatic arterial injury. After 6 to 24 months of follow-up, the sperm density and activity of 18 patients with oligozoospermia were significantly improved, and 19 patients had scrotal pain and discomfort Symptoms disappeared, 7 cases reduced, review B ultrasound showed no obvious scrotal hematoma, testicular atrophy or hydrocele occurred, no recurrence. Conclusion: The improved micro-varicocele ligation guided by mini-vascular Doppler is safe and effective, which avoids the damage of arteries to the arteries and can significantly improve the symptoms and sperm quality of patients with severe varicocele. The curative effect is exact and has the promotion value.