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Thế nào là giãn tĩnh mạch tinh?  

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08:12 03/12/2014

Giãn tĩnh mạch tinh (TMT) là hiện tượng giãn bất thường của tĩnh mạch tinh và đám rối tĩnh mạch tinh. 90 % giãn TMT xảy ra ở một bên và thường là ở bên trái. Lí do chủ yế.. [..]

Giãn tĩnh mạch tinh (TMT) là hiện tượng giãn bất thường của tĩnh mạch tinh và đám rối tĩnh mạch tinh.90% giãn TMT xảy ra ở một bên và thường là ở bên trái. Lí do chủ yếu để người bệnh đi khám là đau tức vùng bẹn bìu hoặc hiếm muộn con cái.


1. Nguyên nhân nào gây giãn TMT?

Cơ chế gây giãn TMT là do không có van hoặc thiểu năng hệ thống van, vì vậy có tràongược máu từ tĩnh mạch thận vào đám rối TMT.

2. Chẩn đoán.

2.1. Lâm sàng.

Khám người bệnh ở tư thế đứng, trong những trường hợp điển hình, có thể dễ dàngnhìn thấy búi giãn tĩnh mạch ở phía trên và

sau tinh hoàn. Mức độ giãn có thể gia tăng hơnkhi làm nghiệm pháp Valsalva.

2.2. Cận lâm sàng.

2.2.1 Siêu âm Doppler mầu.

Siêu âm Doppler mầu cuống mạch tinh hoàn để đánh giá chính xác mức độ giãn TMT. Bình thường khẩu kính tĩnh mạch tinh dưới

2 mm. Gọi là giãn TMT khi có ít nhất một tĩnh mạch trong đám rối tĩnh mạch có đường kínhlớn hơn 2 mm, có hồi lưu khiến phình

to hơn sau khi người bệnh đứng dậy hoặc cho làmnghiệp pháp Valsalva.

3.2.2 Siêu âm và chụp cắt lớp vi tính ổ bụng.

Là những xét nghiệm cần thiết khi có giãn TMT nhằm loại trừ các trường hợp giãnTMT thứ phát do các khối u sau phúc mạc hay

ở tiểu khung chèn ép.

3.2.3 Tinh dịch đồ.

Chỉ định trong những trường hợp vô sinh nhằm đánh giá ảnh hưởng của giãn TMT đốivới chức năng sinh sản tinh trùng.

3.3. Phân độ giãn tĩnh mạch tinh.

  • Độ 0: giãn TMT chưa có biểu hiện lâm sàng, chỉ phát hiện được khi làm các thămdò cận lâm sàng như siêu âm…
  • Độ 1: giãn TMT sờ thấy hoặc nhìn thấy khi làm nghiệm pháp Valsalva.
  • Độ 2: giãn TMT sờ thấy nhưng không nhìn thấy khi đứng thẳng.
  • Độ 3: giãn TMT nhìn thấy hiện rõ ở da bìu khi đứng thẳng.

4. Điều trị phẫu thuật.

4.1. Chỉ định.

  • Giãn TMT gây triệu chứng đau tức vùng bẹn bìu kéo dài ảnh hưởng tới sinh hoạt vàkhả năng lao động.
  • Giãn TMT phát hiện trên một cặp vợ chồng vô sinh.
  • Giãn TMT kết hợp với teo tinh hoàn.
  • Giãn TMT kèm theo bất thường về tinh dịch đồ.

4.2. Nguyên tắc phẫu thuật.

- Cắt và thắt hai đầu tĩnh mạch tinh, làm xẹp hết máu đọng ở phần tĩnh mạch ngoại vi.

- Không làm thương tổn động mạch tinh.

Theo sách bệnh học giới tính nam - NXB Y học

Chú ý: Trên đây là những thông tin mà các bạn có thể tham khảo, để biết thêm chi tiết và được hướng dẫn cụ thể, hãy gọi đến tổng đài 1900.6180 để  nhận được tư vấn trực tiếp từ các bác sĩ.


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