显微镜下双针法输精管附睾管吻合治疗附睾梗阻性无精症34例分析  

Microsurgical double-needle vasoepididymostomy in the treatment of epididymal obstructive azoospermia:an analysis of 34 cases

作　　者：姚雄波 白培德 周奇芬 罗进阳 陈嘉鑫 邢金春[2] 庄炫 YAO Xiong-bo;BAI Pei-de;ZHOU Qi-fen;LUO Jin-yang;CHEN Jia-xin;XING Jin-chun;ZHUANG Xuan(Department of Clinical Medicine,Fujian Medical University,Xiamen 361000;Department of Urology,First Affiliated Hospital of Xiamen University,Xiamen 361000;Basic Medical College, Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学临床医学部,福建厦门361000 [2]厦门大学附属第一医院泌尿外科,福建厦门361000 [3]福建医科大学基础医学院,福建泉州362000

出　　处：《现代泌尿外科杂志》2019年第6期438-440,共3页Journal of Modern Urology

基　　金：厦门市科技计划项目(No.3502Z20174063);福建省科技计划项目(No.2017D0010)

摘　　要：目的分析附睾梗阻所致的无精症患者行显微镜下双针法输精管附睾管吻合术的复通率、自然受孕率及附睾炎病史对手术成功率的影响。方法回顾性分析厦门大学附属第一医院2011年4月至2018年1月收治的34例附睾梗阻所致无精症患者临床资料,并随访术后的精液常规及自然受孕率。结果经术后随访及精液分析发现34例患者中,总体复通率为61.8%(21/34),自然受孕率32.4%(11/34)。其中附睾炎病史患者12人,复通率66.7%(8/12),自然受孕率33.3%(4/12);非附睾炎病史患者22例,复通率59.1%(13/22),自然受孕率31.8%(7/22);两者比较差异有统计学意义(P<0.05)。结论附睾梗阻性无精症应用显微镜下双针法治疗具有良好的疗效,术中采用"台阶法"可有效简化手术操作,同时具有附睾炎病史患者可能具备更高的显微镜输精管附睾管套叠吻合(VE)手术成功率。Objective To analyze the recanalization rate and natural conception rate after microsurgical double-needle vasoepididymostomy in patients with azoospermia caused by epididymal obstruction and the effects of epididymitis history on the success rate of surgery. Methods The clinical data of 34 cases of azoospermia caused by epididymal obstruction treated in our hospital during Apr.2011 and Jan.2018 were retrospectively analyzed,and the semen routine and natural pregnancy rate after operation were followed up. Results The overall recanalization rate was 61.8 %(21/34),and the natural pregnancy rate was 32.4 %(11/34).For the 12 patients with epididymitis history,the recovery rate was 66.7 %(8/12),and the natural pregnancy rate was 33.3 %(4/12).For the 22 patients without epididymitis history,the recovery rate was 59.1 %(13/22),and the natural pregnancy rate was 31.8 %(7/22).There were statistical differences ( P <0.05). Conclusion Microsurgical double-needle vasoepididymostomy is effective for epididymal obstructive azoospermia.The "step method" can effectively simplify the operation,and patients with epididymitis history may have high success rate of operation.

关 键 词：附睾 梗阻性无精症 输精管附睾管吻合 台阶法 附睾炎 

分 类 号：R698.2[医药卫生—泌尿科学]