(秦皇岛市第二医院 河北 秦皇岛 066000)

    【摘要】目的：评价小切口集束型腹膜后精索动静脉高位结扎术的临床效果。方法：回顾性分析60例精索内动静脉高位结扎术的治疗效果。手术简要过程：手术切口长约2cm，逐步切开各层并找见扩张的精索内静脉，同时找到与其伴行的精索动脉，用弯钳将精索自腹膜上分离出并牵出切口，确认精索血管内无输精管后，游离钳夹切断并集束型结扎精索血管，检查无活动性出血，逐层关闭切口。结果：60例手术均效果显著。手术时间15～30 min，平均手术时间25 min；切口长度1.5～2.0cm，平均1.8cm,术时无明显出血及脏器损伤，术后平均住院7天。术后5例出现鞘膜积液。随访3～12个月，3例复发，复发率5%。无一例出现睾丸萎缩或坏死。结论：本术式治疗精索静脉曲张具有损伤小、手术时间短、效果良好等优点。

    【关键词】精索静脉曲张;小切口;集束型;高位结扎术

    The small margin retroperitoneal fine rope moves the vein top digit ligation application experience

    【Abstract】 Goal: Appraises the small margin beaming retroperitoneal fine rope to move the vein top digit ligation the clinical effect. Method: In the review analysis 60 example fine ropes moves the vein top digit ligation the treatment result. Surgery brief process: Surgery margin long approximately 2cm, cuts open each gradually and looks sees the expansion in the fine rope the vein, simultaneously found with its partner line of fine rope artery, separated with the curved pliers the fine rope from the peritoneum on and pulls the margin, confirmed in after the fine rope blood vessel did not have the vas deferens, drifted away the pliers to clamp the cut-off and the beaming ligation fine rope blood vessel, inspected the non-activity hemorrhage, the cascade closure margin. Finally: 60 example surgery even effect is remarkable. Surgery time 15～30 min, average surgery time 25 min; Margin length 1.5～2.0cm, average 1.8cm, when technique not obvious hemorrhage and internal organs damage, after the technique, is hospitalized equally for 7 days. The technique latter 5 examples present the hydrocile. Makes a follow-up visit for 3～12 months, 3 example recrudescences, recurrence rate 5%. Does not have an example to present the atrophia testiculi or necrosis. Conclusion: This technique type treats the fine rope varicosity to have damages, the surgery time to be short slightly, effect good and so on merits. ......