简介:摘要目的探讨胡桃夹综合征(NutcrackerSyndrome,NCS)的手术方式.方法NCS患者11例,临床症状主要表现为蛋白尿和严重的精索静脉淤血曲张,彩色超声及CT示腹主动脉与肠系膜上动脉汇合处角度变小,左肾静脉(leftrenalvein,LRV)变细,行左精索静脉远心端结扎、近心端与髂外静脉吻合术.结果术后3月复查见精液质量大大提高,蛋白尿症状消失,彩超回报新建静脉循环血流畅通.讨论NCS患者临床症状表现多样,应将症状,体征和辅助检查结合起来共同决定手术指征,精索静脉远心端结扎、近心端与髂外静脉吻合术是治疗NCS的方法之一,应排除禁忌症,选择合适病例,长期疗效需进一步的观察.关键词胡桃夹综合征,精索静脉髂外静脉吻合术AbstractObjectiveToexploretheoperationmethodofNutcrackerSyndrome.Method11patientswithNCS,ProteinuriaandseveretesticularveinisthemaGjorclinlcalsymptoms,DopplercolorultrasoundandCTshowedthattheanglebetweentheabdominalaortaandthesuperiormesentericarterybecomessmall,leftrenalveinthinning.Theoperationmethodisprickingthefarheartsideofleftvein,fittingtheoppositesideandvenailiacatogether.ResultthreemonthsaftersurGgery,spermqualityisbetter,Proteinuriadisappeared,colorDopplerultrasoundshowedthatthenewcircularweresmooth.DiscussiontheclinicalsymptomofNCSiscomplex,combinationofsymptomsandauxiliaryexaminationtodetermineindicateonsforsurgery,prickingthefarheartsideofleftvein,fittingtheoppositesideandveKneayiliwaocradstogetherisoneofthemethodstotreatmentNCS,choosethegoodindicateon,longtermefficacyneedsfurtherobservation.nutcrackersyndrome;fittingbetweenspermatidccordveinandexternalvein中图分类号R692.9文献标识码B文章编号1008-6315(2015)12-0671-01