显微镜下睾丸切开取精术治疗非梗阻性无精子症临床效果  

The clinical effect of microdissection of testicular sperm extraction for treating patients with non-obstructive azoospermia

作　　者：陈超 张剑飞 马静 王琇 姚冠峰 CHEN Chao;ZHANG Jianfei;MA Jing;WANG Xiu;YAO Guanfeng(Hebei Science and Technology Academy of Family Planning, Key Laboratory of Family Planning and Eugenics, National Health commission / Key Laboratory of Reproductive Medicine, Shijiazhuang, Hebei Province, 050000;Bethune International Peace Hospital)

机构地区：[1]河北省计划生育科学技术研究院,国家卫生健康委员会计划生育与优生重点实验室/河北省生殖医学重点实验室,石家庄050000 [2]白求恩国际和平医院

出　　处：《中国计划生育学杂志》2020年第3期385-389,共5页Chinese Journal of Family Planning

基　　金：河北省卫生和计划生育委员会指导课题(20180951)。

摘　　要：目的:探讨显微镜下睾丸切开取精术(micro-TESE)治疗非梗阻性无精子症(NOA)效果。方法:回顾性收集2017年7月-2018年12月本院收治的行micro-TESE治疗的NOA 60例及行睾丸穿刺取精术的梗阻性无精子症(OA)48例临床资料。两组配偶均行卵细胞胞质内单精子注射(ICSI)。比较两组助孕效果、NOA治疗前后的性激素水平变化。结果:术后NOA组的卵泡刺激素(FSH)、黄体生成素(LH)高于OA组,睾酮(T)低于OA组,精子获得率(SRR)低于OA组(P<0.05);正常受精率、优胚率、临床妊娠率等NOA组与OA组无差异(P>0.05)。术后1、6个月NOA组的FSH、LH与术前比较无差异(P>0.05),但T、勃起功能IIEF-5评分低于术前(P<0.05)。结论micro-TESE为部分NOA者提供了生育自己生物学子代的机会,其取精成功率高,无明显并发症,但可能一定程度损伤患者睾丸功能。Objective:To investigate the clinical effect of microdissection of testicular sperm extraction(micro-TESE)for treating patients with non-obstructive azoospermia(NOA).Methods:The clinical data of 60 patients with NOA treated by micro-TESE(in group A)and 48 patients with obstructive azoospermia(OA)treated by testicular puncture(in group B)from July 2017 to December 2018 were analyzed retrospectively.The wives of the patients in the two groups received IVF-ET by intracytoplasmic sperm injection(ICSI).The effect of assisted pregnancy,changes of sex hormone levels of patients before and after NOA treatment were compared between the two groups.Results:The levels of FSH and LH of patients in group A were significant higher than those of patients in group B,but T level and sperm acquisition rate(SRR)of the patients in group A were significant lower than those of patients in group B(P<0.05).In 1 month and 6 months after operation,the levels of FSH and LH of patients in the two groups had no significant different(P>0.05),but T level and IIEF-5 scores had decreased significantly(P<0.05).Conclusion:Micro-TESE can provide opportunity for some patients with NOA to have their own biological offspring,which has high success rate of sperm extraction without obvious complications,but it may damage the testicular function of patients to some extent.

关 键 词：非梗阻性无精子症 显微镜下睾丸切开取精术 卵细胞胞质内单精子注射 勃起功能 妊娠结局 

分 类 号：R69[医药卫生—泌尿科学]