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目的了解经脐单孔法无气腹腹腔镜精索静脉高位结扎术治疗精索静脉曲张性不育的临床疗效。方法选取精索静脉曲张患者40例,行经脐单孔法无气腹腹腔镜精索静脉高位结扎术,观察患者的手术时间、术后住院天数、术后并发症及术后3个月时精液质量改善情况。结果 40例患者术后均顺利完成,无明显出血影响手术操作,无严重手术并发症,术后阴囊坠胀不适感均消失或减轻,阴囊触诊扩张迂曲的静脉明显缩小,Valsava试验阴性。其中单侧患者手术时间为18~25 min,平均24.2 min;双侧患者手术时间为35~47 min,平均36.7 min。平均住院时间2.4 d。经过3个月随访,无复发病例,术后3个月复查精液常规,精液质量明显改善,术后精子密度、活率、(A+B)级精子比例与术前比较差异有统计学意义(P<0.05)。结论经脐单孔腹腔镜精索静脉高位结扎术可作为治疗精索静脉曲张性不育的一种可选术式,可取得良好的临床疗效。
Objective To understand the clinical effect of transvaginal laparoscopic varicocele ligation in the treatment of varicocele infertility by transumbilical single hole method. Methods Forty patients with varicocele were selected and treated with pneumoperitoneal laparoscopic varicocele via lumbar umbilical single hole method. The operation time, postoperative hospital stay, postoperative complications and postoperative 3 months postoperative semen Quality improvement. Results All the 40 patients were successfully performed without any hemorrhage. No serious complications were found. All the scrotal distension disappeared or was relieved. The tortuous venous dilatation of the scrotal palpation was significantly reduced. Valsava test was negative. Among them, the operation time of unilateral patients was 18-25 min (average 24.2 min). The operation time of bilateral patients was 35-47 min (average 36.7 min). The average hospital stay was 2.4 days. After 3 months of follow-up, there was no recurrence and sperm routine was observed 3 months after operation. The quality of semen was significantly improved. The postoperative sperm density, viability, (A + B) sperm ratio were significantly different from preoperative P <0.05). Conclusion Single umbilical single hole laparoscopic varicocele ligation can be used as an optional surgical treatment of varicocele infertility, can achieve good clinical efficacy.