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【目的】比较显微外科与开放手术治疗精索静脉曲张的临床疗效。【方法】2011年12月至2013年3月本院149例精索静脉曲张的患者，其中显微外科组84例，腹股沟入路的开放手术组65例。比较两组患者的手术时间，术后住院时间，术后精索静脉曲张复发率，睾丸鞘膜积液发生率及术后3个月精液质量的改善情况。【结果】显微外科组手术时间长于开放手术组（P ＜0．05），术后住院时间短于开放手术组（P ＜0．05）；显微外科组的术后精索静脉曲张复发率及术后睾丸鞘膜积液发生率均低于开放手术组（ P ＜0．05），两组术后精子浓度及精子活力均较术前明显改善（ P ＜0．05）。【结论】显微外科治疗精索静脉曲张可改善精子浓度及精子活力，与开放手术相比，具有恢复快，并发症少的优点。“,”[Objective]To compare clinical efficacy of microsurgery vs open surgery in the treatment of var-icocele .[Methods] Totally 149 patients with varicocele in our hospital from Dec .2011 to March 2013 were di-vided into microsurgery group( n =84) and open inguinal surgery group( n =65) .The operation time ,post-operative hospital stay ,the recurrence rate of postoperative varicocele ,the incidence of hydrocele and the im-provement of semen quality 3 months after surgery were compared between two groups .[Results]The opera-tion time in microsurgery group was longer than that in open surgery group(P<0 .05) ,while the postoperative hospital stay in microsurgery group was shorter than that in open surgery group ( P <0 .05) .The recurrence of postoperative varicocele and incidence of hydrocele in microsurgery group were lower than those in open sur-gery group( P <0 .05) .Compared with before surgery ,sperm concentration and motility in two groups after surgery were obviously improved( P <0 .05) .[Conclusion]Microsurgery for the treatment of varicocele can improve sperm concentration and mobility .Compared with open surgery ,microsurgery has advantages such as rapid recovery and fewer complications .