显微镜下双针与单针缝线纵向套叠式吻合术治疗梗阻性无精子症的比较性研究  

Curative effect analysis of microsurgical single-needle and double-needle longitudinal telescopic anastomosis in the treatment of epididymal obstruction azoospermia

作　　者：向安平 胡政麾[1] 何宁 张炎 吴宏珅 金晓东 Xiang Anping;Hu Zhenghui;He Ning;ZhangYan;Wu Hongshen;Jin Xiaodong(Department of Urology,The First Hospital of Zhejiang University School of Medieine,Hangzhou,Zhejiang,310003,China;Department of Urology,The First People's Hospital of Huzhou,Hiizhou,313000,China)

机构地区：[1]浙江大学医学院附属第一医院泌尿外科,浙江杭州310003 [2]湖州市第一人民医院泌尿外科,浙江湖州313000

出　　处：《中国男科学杂志》2021年第4期35-39,共5页Chinese Journal of Andrology

摘　　要：目的分析显微镜下双针与单针缝线纵向套叠式吻合术在治疗附睾管梗阻性无精子症中的疗效。方法回顾性分析2018年1月-2020年1月44例在浙江大学附属第一医院诊治的附睾管梗阻性无精子症的相关临床资料,其中行双针法吻合的有21例,行单针法吻合的有23例,分析两组患者的临床资料,观察术后的复通率及自然受孕率。结果两组患者的年龄、精液果糖、精液α-葡萄糖苷酶、手术时间、复通率、自然受孕率均无明显统计学差异。显微镜下附睾输精管吻合术的总体复通率为40.9%(18/44)、总体怀孕率为6.8%(3/44);6月内的复通率为38.6%(17/44),12月后复通率为40.9%(18/44)。结论显微镜下双针与单针缝线纵向套叠式吻合术均是治疗附睾管梗阻性无精子症的良好术式,两种手术方式在术后的复通率及自然受孕率上无差异,单针法的平均手术时间比双针法稍长,但单针缝线取材容易、材料经济,特别适用于缺少双针缝线的地区。Objective To analyze the curative effects of microsurgical single-needle and double-needle longitudinal telescopic anastomosison the patients with azoospermia caused by epididymal obstruction. Methods Clinical data of 44 azoospermia patients caused by epididymal obstruction who were treated in the first affiliated hospital of Zhejiang University during Jan. 2018 and Jan. 2020 were retrospectively analyzed. Double-needle anastomosis was performed in 21 cases, and single-needle anastomosis was performed in 23 cases, and the patency rate and natural pregnancy rate were comparatively analyzed. Results There were no significant differences in age, semen fructose, semen α-glucosidase, operation time,recanalization rate and natural pregnancy rate between the two groups. The overall recanalization rate for microscopic vasoepididymostomy was 40.9%(18/44)、 overall pregnancy rate was 6.8%(3/44);Recanalization rate within 6 months was38.6%(17/44), recanalization rate after 6 months was 40.9%(18/44). Conclusion Microsurgical single-needle and double-needle longitudinal telescopic anastomosis are all good methods for patients with azoospermia caused by epididymal obstruction. There are no differences in recanalization rate and natural pregnancy rate between the two methods. The average operation time of single-needle method is slightly longer than that of double-needle method, but the single-needle suture is economical and easy to be obtained, especially suitable for areas lacking double-needle suture.

关 键 词：附睾 梗阻性无精子症 显微镜下输精管附睾吻合术 

分 类 号：R698.2[医药卫生—泌尿科学] R699.8[医药卫生—外科学]