睾丸穿刺活检在卵浆内单精子注射辅助生育中的价值  

The value of testicular biopsy for reproduction by intracytoplasmic sperm injection

作　　者：杨志尚[1] 邢俊平[1] 卢改莲[1] 贺大林[1] 南勋义[1] 

机构地区：[1]西安交通大学医学院第一附属医院泌尿外科,陕西西安710061

出　　处：《现代泌尿外科杂志》2006年第6期338-340,共3页Journal of Modern Urology

摘　　要：目的评价单、双侧睾丸穿刺活检在无精症的病理诊断和卵浆内单精子注射生育中的价值。方法随机对65例无精症患者进行单侧或双侧活检;测量患者睾丸体积,计算手术时间,评估术后并发症,记录病理结果。结果65例无精症患者睾丸穿刺病理结果显示:唯支持细胞综合征41例(63%),生精功能低下10例(15.4%),精子成熟阻滞9例(13.8%),正常生精功能5例(7.8%)。双侧睾丸活检术后出现腰腹疼痛10例、恶心8例,单侧睾丸活检仅2例出现腰腹疼痛。双侧睾丸活检中,病理显示生精状态不同者占50%(15/30)。结论睾丸钳穿活检是一种简单、损伤少的活检方法。单点、单侧睾丸活检可以对无精症进行诊断,但不能反映双侧睾丸的不同生精状态,对欲行卵浆内单精子注射的患者应行双侧睾丸活检,切开获取精子可能是最好的办法。Objective To evaluate the significance of testis biopsy to intracytoplasmic sperm injection （ICSI）. Methods A total of 65 patients with azoospermia aged from 26 to 32 were divided into two groups randomly. 35 cases underwent biopsy in one side of the testis and 30 cases in both sides of testes, respectively. The volume of the testes, operation time, complications, and pathological results were recorded. Results Path.ological analysis showed sertoli-cell-only syndrome in 41 patients （63%）, hypospermatogenesis in 10 patients （15. 4%）, maturation arrest in 9 patients （13. 8%）, and normal spermatogenesis in 5 patients （7.8%）. Lumboabdominal pain appeared in 10 and nausea in 8 of the 30 patients who underwent biopsy in both sides of testes. Lumboabdominal pain appeared in 2 of the 35 patients who underwent biopsy in one side of the testis. 15 of the 30 cases （50%） who underwent biopsy in both sides of testes showed different pathological condition in left and right testis. Conclusion One-point biopsy in the testis is a simple and minimally invasive method for pathological diagnosis in patients with azoospcrmia, but it doesn＇t present the spermatogenic status on both sides of the testes. Biopsy on both sides of the testes for evaluation and testicular incision for extracting spermatozoon might be necessary in the patients who intend to breed by intracytoplasmic sperm injection.

关 键 词：卵浆内单精子注射 活检 睾丸 

分 类 号：R698.2[医药卫生—泌尿科学]