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[1]王婷婷,王笑一,李敬.精索静脉曲张结扎术前和术后超声检查与精液质量变化的相关性研究[J].天津医科大学学报,2024,30(05):452-455.[doi:10.20135/j.issn.1006-8147.2024.05.0452]
 WANG Tingting,WANG Xiaoyi,LI Jing.Correlation between ultrasound parameters and semen quality changes before and after varicocele ligation[J].Journal of Tianjin Medical University,2024,30(05):452-455.[doi:10.20135/j.issn.1006-8147.2024.05.0452]
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精索静脉曲张结扎术前和术后超声检查与精液质量变化的相关性研究(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
30卷
期数:
2024年05期
页码:
452-455
栏目:
临床医学
出版日期:
2024-09-25

文章信息/Info

Title:
Correlation between ultrasound parameters and semen quality changes before and after varicocele ligation
文章编号:
1006-8147(2024)05-0452-04
作者:
王婷婷王笑一李敬
(天津医科大学第二医院超声科,天津300211)
Author(s):
WANG TingtingWANG XiaoyiLI Jing
(Department of Ultrasound,The Second Hospital of Tianjin Medical University,Tianjin 300211,China)
关键词:
精索静脉曲张精索静脉曲张结扎术精液质量超声
Keywords:
varicocelevaricocelectomysemen qualityultrasound
分类号:
R445
DOI:
10.20135/j.issn.1006-8147.2024.05.0452
文献标志码:
A
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。
Abstract:
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 non-reflux 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 spermatic vein(OR=2.227,95% CI:1.142-4.344,P=0.019)was the risk factors for postoperative spermatic vein dilatation. Conclusion:Postoperative ultrasound diagnosis can be used to observe venous reflux.It has certain reference value for evaluating the surgical effect of varicocele.

参考文献/References:

[1] MINHAS S,BETTOCCHI C,BOERI L,et al. European Association of Urology guidelines on male sexual and reproductive health:2021 update on male infertility[J]. Eur Urol,2021,80(5):603-620.
[2] SEILER F,KNEISSL P,HAMANN C,et al. Laparoscopic varicocelectomy in male infertility:improvement of seminal parameters and effects on spermatogenesis[J]. Wien Klin Wochenschr,2022,134(1-2):51-55.
[3] MORINI D,SPAGGIARI G,DAOLIO J,et al. Improvement of sperm morphology after surgical varicocelerepair[J]. Andrology,2021,9(4):1176-1184.
[4] FREEMAN S,BERTOLOTTO M,RICHENBERG J,et al. Ultrasound evaluation of varicoceles:guidelines and recommendations of the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for detection,classification,and grading[J]. Eur Radiol,2020,30(1):11-25.
[5] 包歆悦,万文博,赵晓慧,等. 站立位超声检查在精索静脉曲张伴相关疼痛中的应用价值[J]. 中国超声医学杂志,2023,39(4):449-452.
[6] CVITANIC O A,CRONAN J J,SIGMAN M,et al. Varicoceles:postoperative prevalence--a prospective study with color Doppler US[J]. Radiology,1993,187(3):711-714.
[7] 李宏军.精索静脉曲张手术后患者的管理策略[J].中华泌尿外科杂志,2020,41(4):247-250.
[8] 《精索静脉曲张诊断与治疗中国专家共识》编写组,中华医学会男科学分会.精索静脉曲张诊断与治疗中国专家共识[J].中华男科学杂志,2015,21(11):1035-1042.
[9] ZOLFAGHARK M,MAJIDI H,FEIZZADEH B,et al. Diagnostic accuracy of resistive index of capsular and intratesticular branches of testicular arteries in infertile men with oligoasthenospermia:acase-control study[J]. Biomedicine (Taipei),2020,10(4):18-22.
[10] EBUBEDIKE U R,ENUKEGWU S U,NWOFOR A M. Ultrasound evaluation of testicular vein diameter in suspected cases of varicocele:comparison of measurements in supine and upright positions[J].Niger J Clin Pract,2020,23(7):1004-1007.
[11] 陈振文,谷龙杰.精液分析标准化和精液质量评估——WHO《人类精液检查与处理实验室手册》(第5版)出版[J].中国计划生育学杂志,2012,20(1):58-62.
[12] CARTOC,GANDHI D A,NACKEERAN S,et al. Varicocele is underdiagnosed in men evaluated for infertility:examination of multi-center large-scale electronic health record data[J].Andrologia,2022, 54(10):e14539.
[13] KAVOUSSI P,BIROWO P,SALEH R,et al. Varicocele and male infertility conundrum:making sense of a never-ending story for the busy clinician[J].Arab J Urol,2024,22(1):1-5.
[14] LOTTI F,FRIZZAF,BALERCIA G,et al. The European Academy of Andrology (EAA) ultrasound study on healthy,fertile men:an overview on male genital tract ultrasound reference ranges[J]. Andrology,2022,10 (Suppl 2):118-132.
[15] BERTOLOTTO M,FREEMAN S,RICHENBERG J,et al. Ultrasound evaluation of varicoceles:systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations[J]. J Ultrasound,2020,23(4):487-507.
[16] IERARDI A M,BIONDETTI P,TSETIS D,et al. CIRSE standards of practice on varicocele embolisation[J]. Cardiovasc Intervent Radiol,2023,46(1):19-34.
[17] ALFOZAN M.Effect of varicocelectomy on serum follicle-stimulating hormone and testosterone; the interrelationship between hormonal variables[J].Res Rep Urol,2023,15:47-53.
[18] MUNOZ L C,WONG A,LEWIS K,et al. The evolving landscape of male varicocele pathophysiology in the era of multi-omics:a narrative review of the current literature[J]. Biology (Basel),2024,13(2):80.
[19] SALONIA A,BETTOCCHI C,BOERI L,et al. European Association of Urology guidelines on sexual and reproductive health-2021 update:male sexual dysfunction[J]. Eur Urol,2021,80(3):333-357.
[20] 王靖凯,庞昆,徐鹏,等. 精索静脉显微集束结扎的手术效率及安全性研究[J]. 中华男科学杂志,2023,29(4):331-336.
[21] 吴迪,朱文博,张宝勋. 神经外科显微镜在显微精索静脉曲张手术中的应用[J]. 中国微创外科杂志,2023,29(1):35-39.

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备注/Memo

备注/Memo:
作者简介 王婷婷(1992-),女,医师,硕士,研究方向:医学影像与核医学;通信作者:李敬,E-mail:2297607834@qq.com。
更新日期/Last Update: 2024-09-20