不同附睾吻合部位治疗附睾梗阻性无精症的病例分析  

Case Analysis of Different Epididymal Anastomoses in the Treatment of Epididymal Obstructive Azoospermia

作　　者：李建军 罗勇 张九乐 周预凯 李杰鹏 锁茂华 肖玉坤 Li Jianjun;Luo Yong;Zhang Jiule;Zhou Yukai;Li Jiepeng;Suo Maohua;XiaoYukun(Department of Urology,The First Affiliated Hospial of Dali University,Dali,Yunnan 671000,China;Department of Urology,The First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China)

机构地区：[1]大理大学第一附属医院泌尿男科,云南大理671000 [2]河南大学第一附属医院泌尿外科,河南开封475000

出　　处：《大理大学学报》2021年第8期62-66,共5页Journal of Dali University

摘　　要：目的:探讨附睾-输精管吻合术中不同附睾吻合部位对复通率及其配偶自然受孕率的影响。方法:回顾性分析2015年1月至2018年6大理大学第一附属医院泌尿男科确诊并行附睾-输精管吻合术患者的术中情况及吻合部位,依据吻合部位分为附睾头部组(A组)、附睾体部组(B组)、附睾尾部组(C组),随访期间予以精液常规检查,明确复通情况,通过电话了解其配偶受孕情况。结果:术后33例患者复通成功,复通率为68.75%,其中A、B、C 3组复通率分别为33.33%(3/9),66.67%(12/18)和85.71%(18/21),3组之间复通率差异有统计学意义(χ^(2)=7.647,P=0.017<0.05)。20例患者配偶自然怀孕,自然受孕率为41.67%(20/48),A、B、C 3组配偶自然受孕率分别为11.11%(1/9)、33.33%(6/18)和61.90%(13/21),3组之间配偶自然受孕率比较差异有统计学意义(χ^(2)=7.510,P=0.023<0.05)。结论:在相同吻合条件下,体尾部吻合较头部吻合能明显增加复通率及其配偶自然受孕率。Objective:To explore the effects of different epididymal anastomosis sites of epididymisvasovasostomy(EV)on recanalization rate and natural pregnancy rate.Methods:From January 2015 to June 2018,patients diagnosed with concurrent EV in the department of urology in the First Affiliated Hospital of Dali University were analyzed retrospectively according to the patients intraoperative conditions.According to the epididymal head,body,and tail of the anastomosis site,they are divided into three groups:A,B,and C.During the follow-up,a routine semen examination was performed to clarify the reopening situation.Their spouses pregnancy statuses were followed up through telephone interviews.Results:33 cases of postoperative recanalization were successful,and the postoperative recanalization rate was 68.75%,among which the recanalization rate of the three groups A,B,and C was 33.33%(3/9),66.67%(12/18),and 85.71%(18/21),respectively.The difference among the groups was significant(χ^(2)=7.647,P=0.017<0.05).The spouses of 20 patients were naturally pregnant,and the natural pregnancy rate was 41.67%(20/48).The pregnancy rates of spouses in groups A,B,and C were 11.11%(1/9),33.33%(6/18),and 61.90%(13/21)respectively.The difference among the three groups was significant(χ^(2)=7.510,P=0.023<0.05).Conclusion:Under the same anastomosis conditions,the anastomosis of the body and tail can significantly increase the recanalization rate and natural pregnancy rate compared with the head anastomosis.

关 键 词：附睾梗阻性无精症 附睾-输精管吻合术 吻合部位 复通率 

分 类 号：R699.8[医药卫生—泌尿科学]