日间手术模式在显微镜辅助精索静脉曲张结扎术中的应用
|
摘要
目的:探讨日间手术模式在显微镜辅助精索静脉曲张结扎术中的临床应用效果。方法:回顾性分析我院2015年8月～2016年8月收治的109例行显微镜下精索静脉曲张结扎术患者的临床资料,根据住院时间是否超过24 h分为日间手术组(n=50)和非日间手术组(n=59例),比较两组患者的等待入院时间、手术时间、住院花费、术后并发症发生情况、再住院率、精液质量改善情况以及配偶的自然怀孕率。结果:两组手术时间、术后并发症发生情况、再住院率、精液质量改善和激素水平变化情况以及配偶的自然怀孕率比较差异无统计学意义(P>0.05)。日间手术组的等待入院时间、住院时间和住院花费均少于非日间手术组,差异有统计学意义[(4.22±1.17) d vs.(6.75±1.36)d,(1.48±1.16)d vs.(4.20±0.71)d,(8 150.77±320.99)元vs.(11 912.29±503.48)元,P<0.05]。结论:日间手术模式应用于显微镜精索静脉曲张结扎术是安全、可靠的,缩短了患者等待入院时间、住院时间和住院花费,并且不增加术后并发症及再住院率,不影响精液质量改善及配偶自然怀孕情况,值得推广。
Objective: To evaluate the clinical effect of day-case surgical model in microscopic assisted varicocele ligation surgery. Method: The clinical data of 109 patients undergoing microscopic varicocele ligation were retrospectively analyzed in our hospital from August 2015 to August 2016. All the patients were divided into the day-case surgery group(50 cases) and non-day-case surgery group(59 cases) according to whether the hospitalization time was more than 24 hours. The effectiveness was analyzed by evaluating the time waiting for admission, operation time, hospital cost, postoperative complications, rehospitalization rate, semen quality improvement and spouse' s natural pregnancy rate. Result: There was no significant difference in operative time, postoperative complications, rehospitalization rate, semen quality improvement, hormone levels or spouse' s natural pregnancy rate between two groups(P>0.05). The time waiting for admission(4.22±1.17 vs. 6.75±1.36), postoperative hospital day(1.48±1.16 vs. 4.20±0.71) and hospital cost(8 150.77±320.99 vs. 11 912.29±503.48) were significantly different between two groups(P<0.05). Conclusion: The application of day-case surgical model in the treatment of microscopic varicocele ligation is safe and reliable for it shortens the patient' s waiting time for admission and hospitalization, but not increase postoperative complications or rehospitalization rate, not affect the semen quality improvement or spouse's natural pregnancy. It is worth promoting.
Objective: To evaluate the clinical effect of day-case surgical model in microscopic assisted varicocele ligation surgery. Method: The clinical data of 109 patients undergoing microscopic varicocele ligation were retrospectively analyzed in our hospital from August 2015 to August 2016. All the patients were divided into the day-case surgery group(50 cases) and non-day-case surgery group(59 cases) according to whether the hospitalization time was more than 24 hours. The effectiveness was analyzed by evaluating the time waiting for admission, operation time, hospital cost, postoperative complications, rehospitalization rate, semen quality improvement and spouse' s natural pregnancy rate. Result: There was no significant difference in operative time, postoperative complications, rehospitalization rate, semen quality improvement, hormone levels or spouse' s natural pregnancy rate between two groups(P>0.05). The time waiting for admission(4.22±1.17 vs. 6.75±1.36), postoperative hospital day(1.48±1.16 vs. 4.20±0.71) and hospital cost(8 150.77±320.99 vs. 11 912.29±503.48) were significantly different between two groups(P<0.05). Conclusion: The application of day-case surgical model in the treatment of microscopic varicocele ligation is safe and reliable for it shortens the patient' s waiting time for admission and hospitalization, but not increase postoperative complications or rehospitalization rate, not affect the semen quality improvement or spouse's natural pregnancy. It is worth promoting.
引文
1 Cassinotti E,Colombo E M,Di Giuseppe M,et al.Current indications for laparoscopy in day-case surgery[J].Int J Surg,2008,6 Suppl 1:S93-S96.
2 管日戬,李森,王进,等.左肾静脉受压与精索静脉曲张术后复发关系的探讨[J].临床泌尿外科杂志,2017,32(2):122-126.
3 Niederberger C.Re:varicocele and male factor infertility treatment:a new meta-analysis and review of the role of varicocele repair[J].J Urol,2012,187(2):626-626.
4 Guo S J,Sun Z J,Li W.New insights about the early diagnosis of fertility impairment in varicoceles:the DNA repair gene example[J].Med Hypotheses,2012,78(4):536-538.
5 Zheng Y Q,Gao X,Li Z J,et al.Efficacy of bilateral and left varicocelectomy in infertile men with left clinical and right subclinical varicoceles:a comparative study[J].Urology,2009,73(6):1236-1240.
6 Taniguchi F,Kaponis A,Izawa M,et al.Apoptosis and endometriosis[J].Front Biosci(Elite Ed),2011,3:648-662.
7 Goldstein M.New insights into the etiology and treatment of male infertility[J].J Urol,1997,158(5):1808-1809.
8 林莉,武志刚,翁志梁,等.三种不同手术方式治疗精索静脉曲张的对比研究[J].浙江医学,2014,36(15):1324-1327.
9 徐淳,王海峰.显微镜与腹腔镜下精索静脉结扎术治疗精索静脉曲张的效果比较[J].中国当代医药,2016,23(7):71-73,79.
10 Cayan S,Shavakhabov S,Kadioglu A.Treatment of palpable varicocele in infertile men:a meta-analysis to define the best technique[J].J Androl,2009,30(1):33-40.
11 Suhonen R A,Iivonen M K,Valimaki M A.Day-case surgery patients' health-related quality of life[J].Int J Nurs Pract,2007,13(2):121-129.
12 Esteves S C,Roque M,Agarwal A.Outcome of assisted reproductive technology in men with treated and untreated varicocele:systematic review and meta-analysis[J].Asian J Androl,2016,18(2):254-258.
13 Baazeem A,Belzile E,Ciampi A,et al.Varicocele and male factor infertility treatment:a new meta-analysis and review of the role of varicocele repair[J].Eur Urol,2011,60(4):796-808.
14 Ding H,Tian J,Du W,et al.Open non-microsurgical,laparoscopic or open microsurgical varicocelectomy for male infertility:a meta-analysis of randomized controlled trials[J].BJU Int,2012,110(10):1536-1542.
2 管日戬,李森,王进,等.左肾静脉受压与精索静脉曲张术后复发关系的探讨[J].临床泌尿外科杂志,2017,32(2):122-126.
3 Niederberger C.Re:varicocele and male factor infertility treatment:a new meta-analysis and review of the role of varicocele repair[J].J Urol,2012,187(2):626-626.
4 Guo S J,Sun Z J,Li W.New insights about the early diagnosis of fertility impairment in varicoceles:the DNA repair gene example[J].Med Hypotheses,2012,78(4):536-538.
5 Zheng Y Q,Gao X,Li Z J,et al.Efficacy of bilateral and left varicocelectomy in infertile men with left clinical and right subclinical varicoceles:a comparative study[J].Urology,2009,73(6):1236-1240.
6 Taniguchi F,Kaponis A,Izawa M,et al.Apoptosis and endometriosis[J].Front Biosci(Elite Ed),2011,3:648-662.
7 Goldstein M.New insights into the etiology and treatment of male infertility[J].J Urol,1997,158(5):1808-1809.
8 林莉,武志刚,翁志梁,等.三种不同手术方式治疗精索静脉曲张的对比研究[J].浙江医学,2014,36(15):1324-1327.
9 徐淳,王海峰.显微镜与腹腔镜下精索静脉结扎术治疗精索静脉曲张的效果比较[J].中国当代医药,2016,23(7):71-73,79.
10 Cayan S,Shavakhabov S,Kadioglu A.Treatment of palpable varicocele in infertile men:a meta-analysis to define the best technique[J].J Androl,2009,30(1):33-40.
11 Suhonen R A,Iivonen M K,Valimaki M A.Day-case surgery patients' health-related quality of life[J].Int J Nurs Pract,2007,13(2):121-129.
12 Esteves S C,Roque M,Agarwal A.Outcome of assisted reproductive technology in men with treated and untreated varicocele:systematic review and meta-analysis[J].Asian J Androl,2016,18(2):254-258.
13 Baazeem A,Belzile E,Ciampi A,et al.Varicocele and male factor infertility treatment:a new meta-analysis and review of the role of varicocele repair[J].Eur Urol,2011,60(4):796-808.
14 Ding H,Tian J,Du W,et al.Open non-microsurgical,laparoscopic or open microsurgical varicocelectomy for male infertility:a meta-analysis of randomized controlled trials[J].BJU Int,2012,110(10):1536-1542.