纵向双针套叠显微输精管附睾吻合术治疗梗阻性无精子症疗效研究  

Clinical study of longitudinal double suture intussusception microsurgical vasoepididymostomy for the treatment of obstructive azoospermia

作　　者：孙建华 周梁 季兴哲 张洲 师娟子 邢俊平[2] SUN Jianhua;ZHOU Liang;JI Xingzhe(Center of Assisted Reproductive Technology,Northwest Women and Children’s Hospital,Xi’an 710003)

机构地区：[1]西北妇女儿童医院生殖中心,西安710003 [2]西安交通大学第一附属医院泌尿外科,西安710061

出　　处：《陕西医学杂志》2019年第11期1439-1442,共4页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81771657)

摘　　要：目的:探讨纵向双针套叠显微输精管附睾吻合术治疗附睾梗阻性无精子症的临床疗效。方法:回顾性分析诊断为附睾梗阻性无精子症患者59例的临床资料,59例均实施了纵向双针套叠显微双侧输精管附睾吻合术。按照吻合手术部位分为两组:A组双侧附睾头部吻合28例;B组双侧附睾体尾部吻合31例。比较两组之间的术后复通率及配偶自然妊娠率。术后任何一次精液分析检见精子即定义为复通,随访至配偶怀孕。结果:59例患者均完成了随访,术后43例(72.9%)复通,25例(42.4%)配偶正常受孕。A组术后复通率为60.7%(17/28),B组术后复通率为83.9%(26/31),两组比较差异有统计学意义(P<0.05)。A组术后配偶妊娠率为21.4%(6/28),B组术后配偶妊娠率为61.3%(19/31),两组比较差异有统计学意义(P<0.05)。结论:纵向双针套叠显微输精管附睾吻合术治疗附睾梗阻性无精子症安全可靠,术后可获得满意的复通率和配偶妊娠率,且体尾部吻合术后复通率、配偶妊娠率明显高于头部吻合术。Objective:To investigate the clinical effect of longitudinal double suture intussusception microsurgical vasoepididymostomy in the treatment of epididymal obstructive azoospermia.Methods:A retrospective analysis was made of 59 patients with epididymal obstructive azoospermia.Bilateral vas deferens epididymis anastomosis under longitudinal double suture intussusception microsurgical vasoepididymostomy was performed in all cases.According to the site of anastomosis,there were 28 cases of bilateral epididymis head anastomosis in group A and 31 cases of bilateral epididymis body and tail anastomosis in group B.The difference of the recovery rate and the natural pregnancy rate of the spouse between the two groups was compared.After any semen analysis,the presence of sperm was defined as patency and followed up until the spouse became pregnant.Results:A total of 59 patients were followed up,43 cases(72.9%)were recanalized and 25 cases(42.4%)were normal pregnancy.The patency rate was 60.7%(17/28)in group A and 83.9%(26/31)in group B.There was significant difference between the two groups(P<0.05).Postoperative spouse pregnancy rate was 21.4%(6/28)in group A and 61.3%(19/31)in group B.There was significant difference between the two groups(P<0.05).Conclusion:longitudinal double suture intussusception microsurgical vasoepididymostomy is a safe and reliable method for the treatment of epididymal obstructive azoospermia.Satisfactory patency rate and spouse pregnancy rate can be obtained after operation.The recanalization rate and spouse pregnancy rate after body-tail anastomosis are significantly higher than that after head anastomosis.

关 键 词：梗阻性无精子症 治疗 纵向双针套叠 显微输精管附睾吻术 复通率 配偶妊娠率 

分 类 号：R699.8[医药卫生—泌尿科学]