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目的:评价采用显微镜下精索静脉低位结扎术、腹腔镜精索静脉高位结扎术两种手术方式的疗效及适应证。方法:2010年1月~2012年12月采用显微镜下精索静脉低位结扎术、腹腔镜精索静脉高位结扎术两种手术方式治疗精索静脉曲张患者87例,其中腹腔镜组30例,显微镜组57例,统计分析两组的手术时间、住院时间及治疗费用方面的差异,并比较并发症及症状改善情况、精液质量提高率及复发率。结果:手术时间腹腔镜组显著短于显微镜组[(20±5)min vs(50±5)min],平均住院时间两组无统计学意义[(2.8±0.7)d vs(3.0±0.6)d)],手术费用腹腔镜组高于显微镜组[(9 000±500)元vs(4 500±500)元];显微镜组症状改善明显,并发症少,复发率低,精液质量改善程度优于腹腔镜组。结论:腹腔镜手术特别适合双侧精索静脉曲张的患者,而显微镜手术在改善症状、精液质量提高和复发率方面有优势。
OBJECTIVE: To evaluate the efficacy and indications of two surgical methods of ligation of varicocele under the microscope and laparoscopic varicocele. Methods: From January 2010 to December 2012, 87 patients with varicocele were treated by microsurgical low varicocelectomy and laparoscopic varicocele. Among them, there were 30 cases of laparoscopic group, Group 57 cases, the statistical analysis of the two groups of operation time, hospital stay and treatment costs differences, and to compare complications and symptoms, semen quality improvement and recurrence rate. Results: There was no significant difference between the two groups in mean laparoscopic surgery time ([20 ± 5] min vs (50 ± 5) min] (9 000 ± 500) yuan vs (45 500 ± 500) yuan in the laparoscopic group; the symptom of the microscope group had obvious improvement, less complication, low recurrence rate and better quality of sperm quality In the laparoscopic group. CONCLUSIONS: Laparoscopic surgery is particularly suitable for patients with bilateral varicocele, while microsurgery has advantages in improving symptoms, improving semen quality, and relapse rate.