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目的:探讨左肾静脉受压现象对左侧精索静脉曲张的发生、术后疗效及复发率的影响。方法:回顾性分析2013年7月~2015年3月在我院就诊的520例左侧精索静脉曲张患者的临床资料。520例患者中,146例(28.1%)合并左肾静脉受压现象,排除11例失访者,将其余的135例列为研究组;另374例(71.9%)为单纯性精索静脉曲张患者,排除29例失访者,将其余的345例列为对照组。两组患者均行显微镜下精索静脉结扎术,并分析其术后的精液质量改善情况及复发率。结果:研究组精索静脉曲张直径高于对照组(P<0.05),术后复发率高于对照组(P<0.05);两组患者术后3个月精子浓度、PR级精子及PR+NP级精子百分率均较术前明显改善(P<0.05),但两组之间的差异无统计学意义(P>0.05);研究组术前术后左肾静脉受压程度未见明显加重(P>0.05)。结论:左肾静脉受压的解剖学改变可能是男性左侧精索静脉曲张发生的重要原因,且合并左肾静脉受压患者的精索静脉曲张直径高于单纯精索静脉曲张患者。轻度左肾静脉受压现象可能是左侧精索静脉曲张患者术后复发的又一重要因素。
Objective: To investigate the effect of left renal vein compression on the incidence of left varicocele, postoperative efficacy and recurrence rate. Methods: The clinical data of 520 cases of left varicocele treated in our hospital from July 2013 to March 2015 were retrospectively analyzed. Of the 520 patients, 146 (28.1%) had left renal vein compression, 11 were excluded, and the remaining 135 were included in the study group; another 374 (71.9%) were single varicocele Patients, excluding 29 cases were lost, the remaining 345 cases as a control group. Both groups underwent microsurgical varicocelectomy and analyzed the postoperative sperm quality improvement and recurrence rate. Results: The diameter of varicocele in the study group was higher than that in the control group (P <0.05), and the recurrence rate was higher in the study group than in the control group (P <0.05). The sperm concentration, PR grade sperm and PR + (P <0.05), but there was no significant difference between the two groups (P> 0.05). There was no significant increase in left renal vein compression before and after operation in study group P> 0.05). CONCLUSIONS: Anatomic changes in left renal vein compression may be an important cause of varicocele on the left side of men, and the diameter of varicocele in patients with left renal vein compression is higher than that of varicocele alone. Mild left renal vein compression may be left ventricular varicocele patients with recurrence of another important factor.