彩色多普勒高频超声检查不育症患者精索静脉曲张的价值  

Value of high frequency ultrasound in male infertility with varicocele

作　　者：石富文[1] 王燕[2] 黄珊珊[3] 郭顺利[1] 陈舜珏[1] 刘怡培[1] 

机构地区：[1]石家庄市中心医院功能科,河北石家庄050011 [2]河北医科大学第二医院功能科,河北石家庄050000 [3]北京大学深圳医院超声影像科,广东深圳518036

出　　处：《中国医学影像技术》2008年第1期111-114,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨高频彩超检查不育症患者精索静脉曲张(VC)的价值及VC对生育力的影响。方法检测32例正常人及116例不育症患者的精索静脉及睾丸,记录精索静脉在平静呼吸时最大内径(D_R)及Valsalva试验时的最大内径(D_V)、最大返流速度(V_(max))及返流持续时间(T_R),测量并计算睾丸体积。每位受检者取精液送检,重点观察精子密度和活动率。结果①各VC组与对照组D_R、D_V、V_(max)、T_R比较及组间两两比较的差别均具有显著性意义(P<0.01)。②各VC组左侧睾丸体积小于对照组(P<0.01)。VCⅢ级组右侧睾丸体积小于对照组(P<0.05)。③各VC组精子密度低于对照组(P<0.05,P<0.01),精子活动率低于对照组(P<0.01),各VC组之间两两比较精子活动率差别均有统计学意义(P<0.05)。结论高频超声可为男性不育精索静脉曲张患者提供精确的精索静脉内径、血流动力学参数及睾丸大小等客观指标,有助于男性不育症病因的筛选及对生育力的评价。Objective To investigate the value of high frequency ultrasound in examing male infertility with varicocele, and discuss the effect of varicocele on fertility. Methods Thirty-two healthy male volunteers （contral group）and 116 infertile men （infertility group） with left varicocele were examined. All the patients were divided into four subgroups. Internal spermatic vein diameter （DR） and testis volume were observed in a normal way. Such signs as internal spermatic vein diameter （Dv）, the peak velocity of reflux （Vmax） and reflux time （TR） were detected in Valsalva-test. Spermatozoid density and activity were tested. Results （1）DR, Dv, Vmax and TR among the four, subgroups and contral group were statistically significant （P〈0.01）. The differences among four subgroups were statistically significant each other （P〈0.01）. Left testis volume of four subgroups was smaller than that of the control group （P〈0.01）. Difference of spermatozoid density between all the four subgroups and contral group was statistically significant （P〈0.05,P〈0.01）. Difference of spermatozoid activity between all the four subgroups and control group was statistically significant （P〈0. 01）. There were significant differences of spermatozoid activity among four subgroups each other （P〈0. 05）. Conehlsion There Was significant positive correlation between severity of varicocele and internal spematic vein diameter, the peak velocity of reflux and reflux time respectively. Varicocele can cause testis volume and spermatozoid density and activity to decrease. High frequency ultrasound can provide the accurate internal spematic vein diameter, hemodynamics and the testis volume for observing male infertility caused by varicocele. It helps to screen the reason and to assess the fertility of male infertility.

关 键 词：高频超声 不育症 精索静脉曲张 睾丸体积 生育力 

分 类 号：R445.1[医药卫生—影像医学与核医学] R697.24[医药卫生—诊断学]