探究腹腔镜完全腹膜外补片修补术（TEP）联合精索静脉高位结扎治疗腹股沟疝合并精索静脉曲张的疗效。

回顾性分析2016年3月至2019年5月湖北省公安县人民医院收治的82例腹股沟疝合并精索静脉曲张患者资料。按照治疗方法分为对照组（49例，TEP治疗）和试验组（33例，TEP联合精索静脉高位结扎治疗），比较两组患者手术时间、排气时间、住院时间、治疗前后精液参数、精索静脉曲张疗效及并发症发生情况。

试验组患者手术时间、住院时间均长于对照组，差异均有统计学意义（t=40.196、6.893，均P<0.001）。术后7 d比较，试验组精子密度、A级精子比例均高于同期对照组，畸形率更低，差异均有统计学意义（P<0.05）。试验组的精索静脉曲张疗效（Z=15.444，P<0.001）及并发症发生率（χ²=7.009，P=0.008）均显著优于对照组患者。

相比于单纯TEP手术，TEP联合精索静脉高位结扎术治疗腹股沟疝合并精索静脉曲张的临床治疗效果较好，患者症状改善时间也相对较短。

To investigate the efficacy of total extraperitoneal patch repair (TEP) combined with high ligation of spermatic vein in the treatment of patients with inguinal hernia combined with varicocele.

From March 2016 to May 2019, eighty-two cases of inguinal hernia complicated with varicocele in People's Hospital of Gongan County were studied. The patients were divided into control group (49 cases, TEP treatment) and trial group (33 cases, TEP combined with high ligation of spermatic vein), and the differences of operation time, exhaust time, hospital stay, semen parameters, efficacy of varicocele and complications were compared between the two groups.

The operation time and the hospitalization time of the trial group was longer than those of the control group, with statistically significant differences (t=40.196, 6.893, both P<0.001). Seven days after the operation, the sperm density and the proportion of A-level sperm in the trial group were both higher than those in the control group, and the abnormality rate was lower, with statistically significant differences (P<0.05). The efficacy and complications of varicocele in the trial group were better than those in the control group, with statistically significant differences (Z=15.444, P<0.001; χ²=7.009, P=0.008).

Compared with TEP alone, TEP combined with high ligation of spermatic vein in the treatment of inguinal hernia combined with varicocele shows better clinical effect and a relatively short symptoms improvement time.