摘要
目的:探讨精索静脉曲张手术前后超声检查参数和精液质量的变化及其相关性,明确术后超声的诊断价值。方法:分析2021年1月—2023年12月在天津医科大学第二医院行精索静脉曲张结扎术患者术前和术后3个月超声检查结果和精液质量的变化。根据术后返流情况,将患者分为无返流组(141例)和返流组(11例),并比较两组手术前后精液质量和睾丸超声检查结果方面的变化。再根据术后精索静脉内径情况,将无返流组患者分为恢复组(78例)和扩张组(63例),分析术后精索静脉扩张的危险因素。结果:与术前相比,无返流组在精液量、精子浓度、总活力和睾丸体积方面显著改善(z=-2.036、-2.628、-2.065、-2.378,均P<0.05,);而返流组患者在精液量、精子浓度、总活力和睾丸体积方面没有明显改善(z=-1.289、-1.183、-1.183、-0.508,均P>0.05)。Logistic回归分析显示,精索静脉内径(OR=2.227,95%CI:1.142~4.344,P=0.019)是术后精索静脉扩张的危险因素。结论:术后超声检查可用于观察静脉返流情况,对精索静脉曲张手术效果的评估有一定的参考价值。
Objective:To analyze the changes and correlation between ultrasound examination parameters and semen quality before and after varicocele surgery,and explore the diagnostic value of postoperative ultrasound.Methods:The changes of ultrasound findings and semen quality in patients undergoing varicocele ligation from January 2021 to December 2023 were analyzed before and about 3 months after surgery in the Second Hospital of Tianjin Medical University.The patients were divided into non-reflux group(n=141)and reflux group(n=11)according to the postoperative reflux.The changes of semen quality and testicular ultrasound parameters before and after surgery were compared between the two groups.According to the diameter of the spermatic vein after surgery,the patients in the nonreflux group were divided into the recovery group(n=78)and the dilatation group(n=63),and the risk factors of postoperative spermatic vein dilation were analyzed.Results:The results showed that the patients in the no-reflux group had significant improvements in semen volume,sperm concentration,total motility and testicular volume compared with those before surgery(z=-2.036,-2.628,-2.065,-2.378,all P<0.05).However,there was no significant improvement in semen volume,sperm concentration,total motility and testicular volume in the reflux group(z=-1.289,-1.183,-1.183,-0.508,all P>0.05).Logistic regression analysis showed that the diameter of the spermat-ic vein(OR=2.227,95%CI:1.142-4.344,P=0.019)was the risk factors for postoperative spermatic vein dilatation.Conclusion:Postop-erative ultrasound diagnosis can be used to observe venous reflux.It has certain reference value for evaluating the surgical effect of varic-ocele.
作者
王婷婷
王笑一
李敬
WANG Tingting;WANG Xiaoyi;LI Jing(Department of Ultrasound,The Second Hospital of Tianjin Medical University,Tianjin 300211,China)
出处
《天津医科大学学报》
2024年第5期452-455,共4页
Journal of Tianjin Medical University
