精索静脉曲张(传)

手术治疗原发性精索静脉曲张效果及方式评价吴小候重庆医科大学附属第一医院泌尿外科定义及分类精索静脉曲张是指精索内蔓状静脉丛的异常伸长、扩张和迂曲。临床上可分为：原发性精索静脉曲张、亚临床型精索静脉曲张、继发性精索静脉曲张三类。流行病学约占成年男性人群的10％－15％，精液异常男性人群发病率25%，不育症男性人群发病率40%。病理生理改变静脉压力升高导致睾丸灌注不足阴囊局部温度升高肾源性毒性物质返流局部代谢物质聚集临床表现及危害睾丸生长发育停滞阴囊及会阴部疼痛或不适精液质量下降及男性不育睾丸Leydig细胞功能衰退精索静脉曲张的治疗方式观察随访药物治疗介入栓塞治疗手术治疗手术治疗精索静脉曲张的效果评价22prospectivestudies，Therandomeffectmodelwasused(heterogeneityχ2=1210.92[df=21];p0.0001)percentspermmotilityin17studies，Therandomeffectmodelwasused(heterogeneityχ2=4308.19[df=16];p0.0001)progressivespermmotilityinfivestudies，Therandomeffectmodelwasused(heterogeneityχ2=16.23[df=4];p=0.003)anincreaseinantioxidantcapacity,adecreaseinoxidativestress,AreductioninspermDNAoxidativedamageasignificantimprovementinpostoperativesemenparametersandDFI精索静脉曲张的手术治疗方式经腹股沟精索静脉高位结扎术经腹膜后精索静脉高位结扎术腹腔镜下精索静脉高位结扎术显微镜下精索静脉结扎术传统的开放手术经腹股沟精索静脉高位结扎术经腹膜后精索静脉高位结扎术腹腔镜下精索静脉高位结扎术显微镜下精索静脉结扎术常用手术方式的效果评价PostoperativespontaneouspregnancyratesamongdifferenttechniquesPostoperativerecurrenceandhydroceleformationratesamongdifferenttechniquesInconclusion,Openmicrosurgicalinguinalorsubinguinalvaricocelectomytechniqueshavebeenshowntoresultinhigherspontaneouspregnancyratesandfewerrecurrencesandpostoperativecomplicationsthanconventionalvaricocelectomytechniquesininfertilemen.谢谢