显微镜下“双钳法”输精管结扎术临床分析  

Clinical Analysis of"Double Forceps"Vasectomy under Microscope

作　　者：李云龙 朱俊超 柳乐毅 卢慕峻[2] Li Yunlong;Zhu Junchao;liu Leyi;Lu Mujun(Department of urology,kunshan first people's hospital,Jiangsu 215300;Department of andrology,renji hospital,medical college,Shanghai jiao tong university,Shanghai 200080)

机构地区：[1]昆山市第一人民医院泌尿外科,江苏215300 [2]上海交通大学医学院附属仁济医院男科,上海200080

出　　处：《中国男科学杂志》2020年第4期53-56,共4页Chinese Journal of Andrology

基　　金：昆山市科技发展专项项目(KS18062);江苏大学临床科技发展项目(JLY20180110)。

摘　　要：目的探讨显微镜下"双钳法"输精管结扎术疗效。方法显微镜下"双钳法"输精管结扎术26例,行阴囊中缝处无血管区纵行切口,先行右侧输精管结扎,用一把皮内输精管固定钳钳夹固定输精管,再用另一把皮内输精管固定钳钳夹交替将输精管移至近皮肤切口处,在放大10倍显微镜下仔细分离,电刀精准止血。切断输精管后,在显微镜下仔细辨认输精管断端的外形,用高频电刀电凝烧灼输精管的断端,结扎近端输精管残端放回,结扎远端输精管残端,行阴囊筋膜穿洞后,钳夹结扎线拉出筋膜外固定。同法处理左侧输精管。结果术中未发生出血血肿;皮下淤血2例,发生率7.70%;阴囊血肿0例,发生率0%;术后切口感染1例,发生率3.85%;发生痛性结节0例,发生率0%;术后再通1例,发生率3.85%;附睾淤积症1例,发生率3.85%。结论显微镜下"双钳法"输精管结扎术是一种安全、高效的手术方法,值得临床推广。Objective To evaluate the clinical effect of"double clamp method"vasectomy under the microscope.Methods Clinical data of 26 cases who underwent microscopic"double clamp method"vasectomy were retrospectively analyzed.They received lines of scrotal raphe avascular area longitudinal incision,the first on the right side of vasectomy,with a fixed clamp clamps intradermal vas deferens fixed vas deferens,again with another pair of intradermal vas deferens fixed clamp clamps the vas deferens alternately moved near the skin incision,carefully separation under 10 x magnification microscope,electric knife precision to stop the bleeding.After the vas deferens were cut off,the appearance of the broken end of the vas deferens was carefully identified under a microscope.The broken end of the vas deferens was electrocoagulated and cauterized with a high-frequency electric knife.The proximal end of the vas deferens was ligated and put back.The left vas deferens was treated in the same way.Results No bleeding hematoma occurred during the operation.Of all the treated cases,2 cases had subcutaneous congestion during operation,accounting for 7.70%,and no one had scrotal hematoma,accounting for0%.One case had postoperative wound infection,accounting for 3.85%.No one had painful nodules,accounting for 0%.One case(3.85%)had postoperative recanalization.And one case had epididymal sedimentation,accounting for 3.85%.Conclusion"Double forceps"vasectomy under the microscope is a safe and efficient surgical method,which is worthy of clinical promotion.

关 键 词：显微镜 输精管结扎术 治疗结果 

分 类 号：R699.8[医药卫生—泌尿科学]