改良单针缝线纵向套叠显微输精管附睾吻合术后一年结果分析  

Retrospective analysis of one-year outcomes after modified single-armed suture technique for microsurglcal intussusception vasoepididymostomy

作　　者：赵亮[1] 涂响安[1] 庄锦涛[1] 王文卫[1] 陈羽[1] 邓春华[2] 曾令友[1] 

机构地区：[1]中山大学附属第一医院东院泌尿外科,广州510700 [2]中山大学附属第一医院泌尿外科

出　　处：《中华显微外科杂志》2016年第2期135-137,共3页Chinese Journal of Microsurgery

基　　金：广东省科技计划资助项目（20128031800361）

摘　　要：目的回顾性分析附睾梗阻性无精症患者接受改良单针缝线显微输精管附睾吻合术后1年的结果。方法2012年2月至2013年11月，应用改良单针缝线技术为51例附睾梗阻性无精症患者实施显微纵向套叠输精管附睾吻合术，随访期1年，对附睾液中精子活动力、双／单侧吻合、吻合部位、女方年龄等与复通率、怀孕率的关系进行分析。结果随访39例（76．5％），其中24例（61．5％）复通，包括1例接受夫精体外受精者共15例（38．5％）怀孕。复通和未复通患者中分别有14例（58-3％）和3例（20．0％）在附睾液中找到活动精子（P〈0．05）；复通组中，怀孕和未怀孕的女方平均年龄分别是26．5和32．7岁（P〈0．05）。结论改良单针缝线技术取得了合理的复通率和怀孕率，是无特制双针缝线地区的理想选择。Objective To retrospectively analyze the one-year outcomes of modified single-armed suture technique for microsurgical vasoepididymostomy in men with epididymal obstructive azoospermia （EOA）. Methods From February, 2012 to November, 2013, microsurgical longitudinal intussusception vasoepididymostomies using a modified single-armed suture technique in 51 men with EOA was performed. The followed-up period was designed as 1 year. The correlations between the sperm motility in epididymal fluid, unilateral or bilateral procedure, anastomotic site, and the female partner age and the patency or pregnancy rate were analyzed. Results Followups were carried out for 39 （76.5%） men. The patency was noted in 24 （61.5%） men and pregnancy was reported in 15 （38.5%） female partners, including 1 received in vitro fertilization using fresh ejaculated sperm. Motile sperms in epididymal fluid were observed intraoperatively in 14 （58.3%） patent men and 3 （20.0%） nonpatent men, respectively （P 〈 0.05）. In patent cohort, the mean ages of the pregnant and non-pregnant female partners were 26.5 and 32.7 years（P 〈 0.05）, respectively. Conclusion The modified single-armed suture technique showed favourable patency and pregnancy rates in this study. It＇s a practical alternative in the areas without the specialized double armed suture.

关 键 词：输精管附睾吻合术 附睾梗阻 梗阻性无精症 复通率 显微外科手术 

分 类 号：R699.8[医药卫生—泌尿科学]