双侧精索静脉曲张显微外科结扎术治疗少/弱精子症疗效分析(109例报道)  

Effect of bilateral microsurgical subinguinal varicocelectomy on asthenozoospermia and oligozoospermia: A report of 109 cases

作　　者：张兴源[1] 史卿菁 潘连军[1] 潘锋[1] 赵丹[1] 张峰磊[1] ZHANG Xing-yuan;SHI Qing-jing;PAN Lian-jun;PAN Feng;ZHAO Dan;ZHANG Feng-lei(Department of Urology and Andrology,Women's Hospital of Nanjing Medical University/Nanjing Maternity and Child Health Hospital,Nanjing,Jiangsu 210002,China;Department of Reproductive Health,Yixing Maternity and Child Health Hospital,Yixing,Jiangsu 214200,China)

机构地区：[1]南京医科大学附属妇产医院/南京市妇幼保健院泌尿男科,江苏南京210002 [2]宜兴市妇幼保健院生殖健康科,江苏宜兴214200

出　　处：《中华男科学杂志》2020年第8期713-716,共4页National Journal of Andrology

摘　　要：目的:研究双侧精索静脉曲张显微外科低位结扎术(BMSV)对少/弱精子症不育患者精液常规指标及生育结局的改善情况。方法:对2018年1月至2019年5月间因男性不育在南京市妇幼保健院泌尿男科行BMSV的147例患者进行了回顾性分析,资料完整者109例,比较手术前、后1次射精精子总数、精子浓度及精子活力的变化,回访术后配偶受孕情况。结果:BMSV手术治疗弱精子症的总有效率(前向运动精子百分比较术前提升≥20%)为79.00%,显效率(前向运动精子百分比较术前提升≥50%)为70.00%,术后显著改善等待时间(110.13±37.43)d;治疗少精子症改善精子浓度总有效率(精子浓度较术前提升≥20%)为74.29%,显效率(精子浓度较术前提升≥50%)为71.43%,显著改善等待时间为(117.00±48.79)d;术后自然受孕率为30.30%,平均受孕等待时间(4.55±2.10)个月。未见术后严重不良反应。结论:BMSV治疗少/弱精子症有显著的临床疗效。Objective: To investigate the effects of bilateral microsurgical subinguinal varicocelectomy(BMSV) in patients with asthenozoospermia or oligozoospermia. Methods: Totally 147 patients with male infertility received BMSV from January 2018 to May 2019, of whom 109 had complete data recorded. We retrospectively analyzed the clinical data, including the total sperm count per ejeculate, sperm concentration and sperm motility before and after surgery, and the rate of natural conception achieved during the follow-up. Results: BMSV achieved a total effectiveness rate of 79.00% in improving the percentage of progressively motile sperm(a rise of ≥20%) and a marked effectiveness rate of 70.00%(a rise of ≥50%) in the 100 cases of asthenozoospermia as compared with the baseline, with a mean recovery time of(110.13 ± 37.43) days. Besides, a total effectiveness rate of 74.29%(an increase of ≥20%) and a marked effectiveness rate of 71.43%(an increase of ≥50%) were attained in the improvement of sperm concentration in the 35 cases of oligozoospermia, with a mean recovery time of(117.00 ± 48.79) days. A natural conception rate of 30.30% was observed during the follow-up. No severe adverse events occurred postoperatively. Conclusion: BMSV is significantly effective for the treatment of asthenozoospermia and oligozoospermia.

关 键 词：双侧精索静脉曲张显微外科结扎术 少/弱精子症 精子总数 精子活力 受孕率 男性不育 

分 类 号：R698.2[医药卫生—泌尿科学]