青少年精索静脉曲张矫治的可能性:一项初步研究

Yu. V. Kutsebo, E. A. Shchuchkina, N. Kozlova
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Two groups were formed: the main group (20 patients), whose participants received drug treatment and a course of osteopathic correction, and the control group (20 patients, data were collected retrospectively), whose participants received only drug therapy. For both groups, there were collected the parameters (before and after treatment) that characterize the state of the venous network of the spermatic cord (presence/absence of testicular hypotrophy, of cremaster reflex and of a positive Valsalva test; as well as the diameter of the cremaster veins and the value of the resistance index), and information on the presence/absence of pain syndrome.Results. In the control group, whose participants received only drug therapy, there was a significant (p<0,05) increase in the number of detected cases of pain syndrome and a positive Valsalva test, as well as a significant (p<0,05) increase in cremaster vein diameter at the end of treatment. 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引用次数: 0

摘要

介绍。目前,精索静脉曲张在泌尿外科仍然是一个很大程度上未解决的问题,这使得有必要寻找额外的,包括非药物的治疗方法。近年来,骨科矫正慢性静脉功能不全患者的有效性已得到证实。然而,目前使用整骨疗法治疗精索静脉曲张的应用并不广泛,这使得开展本课题的研究具有重要意义。目的是探讨使用整骨矫正青少年精索静脉曲张的可能性。材料和方法。这项研究涉及40名年龄在13-17岁之间的参与者。分为两组:主组(20例)接受药物治疗并进行一个疗程的整骨矫正;对照组(20例)仅接受药物治疗,资料回顾性收集。对于两组患者,收集了表征精索静脉网络状态的参数(治疗前后)(是否存在睾丸萎缩、cremaster反射和Valsalva试验阳性);以及脉径和阻力指数的值),以及有无疼痛综合征的信息。在只接受药物治疗的对照组中,疼痛综合征的检测病例和Valsalva试验阳性的数量显著(p< 0.05)增加,治疗结束时冠状静脉直径显著(p< 0.05)增加。主组患者在保守治疗的基础上进行整骨矫正,其特征是嵴静脉直径明显减小(p< 0.05),阻力指数明显升高(p< 0.05),结果与对照组的相应值有显著差异(p< 0.05)。治疗结束时,主组疼痛综合征、Valsalva试验阳性、无cremaster反射的发生率均低于对照组,差异有统计学意义(p< 0.05)。在这项初步研究的框架内获得的结果使我们能够积极评估在青少年精索静脉曲张治疗中使用整骨矫正的前景。建议在更长的时间和更大的样本量上继续在这个方向上进行研究,并必须形成平行对照。
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The possibilities of osteopathic correction using in adolescents with varicocele: a pilot study
Introduction. Currently, varicocele remains a largely unresolved problem in urology, and this makes it necessary to search for additional, including non-pharmacological, methods of treatment. In recent years, the effectiveness of osteopathic correction of patients with chronic venous insufficiency has been shown. However, at this moment, the use of osteopathic methods in the treatment of varicocele is not widely used, which makes it relevant to conduct research on this topic.The aim is to explore the possibility to use the osteopathic correction in adolescents with varicocele.Materials and methods. The study involved 40 participants aged 13–17 years. Two groups were formed: the main group (20 patients), whose participants received drug treatment and a course of osteopathic correction, and the control group (20 patients, data were collected retrospectively), whose participants received only drug therapy. For both groups, there were collected the parameters (before and after treatment) that characterize the state of the venous network of the spermatic cord (presence/absence of testicular hypotrophy, of cremaster reflex and of a positive Valsalva test; as well as the diameter of the cremaster veins and the value of the resistance index), and information on the presence/absence of pain syndrome.Results. In the control group, whose participants received only drug therapy, there was a significant (p<0,05) increase in the number of detected cases of pain syndrome and a positive Valsalva test, as well as a significant (p<0,05) increase in cremaster vein diameter at the end of treatment. Participants of the main group, who received osteopathic correction in addition to conservative therapy, were characterized by a significant (p<0,05) decrease in the diameter of the cremaster veins and an increase in the resistance index, the results differed significantly (p<0,05) from the corresponding values in the control group. Also, in the main group at the time of completion of treatment, there were recorded a statistically significantly (p<0,05) lower number of cases of pain syndrome, a positive Valsalva test, and the absence of a cremaster reflex in comparison with the control group.Conclusion. The results obtained in the framework of this pilot study allow us to positively assess the prospects for the use of osteopathic correction in the treatment of varicocele in adolescents. It is recommended to continue research in this direction over a longer period of time and on a larger sample size, with the obligatory formation of a parallel control.
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