接受显微外科精索静脉曲张切除术患者的精索静脉曲张静脉血气模式。
Pattern of varicocele vein blood gases in patients undergoing microsurgical Varicocelectomy.
作者信息
Rehman Khaleeq Ur, Zaneb Hafsa, Qureshi Abdul Basit, Numan Ahsan, Yousaf Muhammad Shahbaz, Rabbani Imtiaz, Rehman Habib
机构信息
Department of Urology & Andrology, FMH College of Medicine & Dentistry, Shadman, Lahore, Pakistan.
Department of Anatomy and Histology, University of Veterinary and Animal Sciences, Lahore, Pakistan.
出版信息
BMC Urol. 2018 Nov 13;18(1):104. doi: 10.1186/s12894-018-0411-y.
BACKGROUND
Varicocele is known to be associated with infertility and sperm disorders. The exact cause of this ailment is not fully understood. There are limited numbers of studies where venous blood gases (VBGs) of varicocele veins were determined with conflicting results. Therefore, we have investigated the pattern of VBGs in both internal spermatic and external spermatic varicocele veins and correlation with semen quality parameters in infertile individuals who underwent left microsurgical varicocelectomy.
METHODS
Patients (n = 27) undergoing left microsurgical varicocelectomy at a tertiary care hospital, were included in the study. Before surgery, semen parameters and scrotal color Doppler ultrasonography was performed. During surgery, blood sample was drawn from varicocele veins (internal spermatic and external spermatic veins) and a peripheral arm vein of the same patient as a control. The VBGs of all veins under study were estimated and compared with each other. The VBGs were also correlated with various semen quality parameters. Data, expressed as Mean ± SD, regarding VBGs in three veins were analyzed using one-way ANOVA. The correlation between VBGs and semen quality parameters was determined using Pearson's correlation. Differences were considered significant at p < 0.05.
RESULTS
The pH was found to be higher (p < 0.01) in the internal spermatic vein compared with the external spermatic and the peripheral veins. Partial pressure of oxygen (pO) and oxygen saturation (sO) were higher (p < 0.01) in the internal spermatic vein compared with the peripheral vein. However, concentration of bicarbonate (HCO was lower (p < 0.01) in both veins compared with the peripheral vein. Partial pressure of carbon dioxide (pCO) was also lower (p < 0.01) in the varicocele veins compared with the control vein.
CONCLUSION
The internal spermatic veins had higher pH and oxygen tension, but lower HCO and pCO levels compared with the control peripheral veins. External spermatic veins had lower pCO and HCO but other VBGs were similar to the peripheral veins. The shift of VBGs of internal spermatic vein toward arterial blood pattern may be a missing link to understand the pathophysiology of varicocele.
背景
精索静脉曲张与不育和精子异常有关。这种疾病的确切病因尚未完全明确。对精索静脉曲张静脉血气体（VBGs）进行测定的研究数量有限，结果相互矛盾。因此，我们研究了精索内静脉和精索外静脉曲张静脉的VBGs模式，以及与接受左侧显微精索静脉结扎术的不育个体精液质量参数的相关性。
方法
本研究纳入了一家三级医院接受左侧显微精索静脉结扎术的患者（n = 27）。手术前，进行精液参数和阴囊彩色多普勒超声检查。手术过程中，从精索静脉曲张静脉（精索内静脉和精索外静脉）以及同一患者的外周手臂静脉采集血样作为对照。对所有研究静脉的VBGs进行评估并相互比较。VBGs还与各种精液质量参数相关。以均值±标准差表示的关于三条静脉VBGs的数据采用单因素方差分析进行分析。使用Pearson相关性分析确定VBGs与精液质量参数之间的相关性。p < 0.05时差异被认为具有统计学意义。
结果
发现精索内静脉的pH值高于精索外静脉和外周静脉（p < 0.01）。与外周静脉相比，精索内静脉的氧分压（pO）和氧饱和度（sO）更高（p < 0.01）。然而，与外周静脉相比，两条精索静脉曲张静脉中的碳酸氢盐浓度（HCO）均较低（p < 0.01）。与对照静脉相比，精索静脉曲张静脉中的二氧化碳分压（pCO）也较低（p < 0.01）。
结论
与对照外周静脉相比，精索内静脉的pH值和氧张力较高，但HCO和pCO水平较低。精索外静脉的pCO和HCO较低，但其他VBGs与外周静脉相似。精索内静脉的VBGs向动脉血模式的转变可能是理解精索静脉曲张病理生理学的一个缺失环节。
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