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显微外科分流术治疗精索静脉曲张合并弱精子症:附3例报告

[Treatment of varicocele combined with asthenospermia by microsurgical shunt: 3 cases report].

作者信息

Wang Shuang, Zu Xiongbing, Liu Longfei, Tang Juyu, Hu Xiheng

机构信息

Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008, China.

Department of UrologyXiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Oct 28;42(10):1228-1231. doi: 10.11817/j.issn.1672-7347.2017.10.017.

Abstract

To investigate the clinic value of microsurgical shunt for the treatment of varicocele combined with asthenspermia, the clinical data and therapeutic method for 3 patients, who conducted the microscope spermatic vein high ligation combined with superficial epigastric vein flow, were retrospectively analyzed. No postoperative complications were found, and the original symptoms and signs were disappeared. All patients were conducted scrotal ultrasound and semen routine after 3 months, and all indexes, including maximum internal diameter of the cord vein (erect position), sperm density, sperm survival rate, sperm deformity rate and sperm forward movement rate, were gradually improved. Consequently, high ligation of spermatic vein combined with vascular bypass surgery under the microscope can block the countercurrent venous blood and establish a new return channel to the testis. Meanwhile, it can also protect the testicular artery and lymph-vessel. It is worth to be spread for the treatment of varicocele combined with asthenospermia.

摘要

为探讨显微外科分流术治疗精索静脉曲张合并弱精子症的临床价值,回顾性分析3例行显微镜下精索静脉高位结扎联合腹壁浅静脉转流术患者的临床资料及治疗方法。术后未发现并发症,原有症状和体征消失。术后3个月对所有患者进行阴囊超声和精液常规检查,包括精索静脉最大内径(直立位)、精子密度、精子存活率、精子畸形率和精子前向运动率等各项指标均逐渐改善。因此,显微镜下精索静脉高位结扎联合血管搭桥手术可阻断静脉逆流血液,建立新的睾丸回流通道。同时,还可保护睾丸动脉和淋巴管。该方法值得推广用于治疗精索静脉曲张合并弱精子症。

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