既往附睾炎对附睾梗阻患者行输精管附睾吻合术后复通率的影响  

Influence of epididymitis history on the results of vasoepididyostomy in patients with epididymal obstruction

作　　者：唐渊[1] 刘建家 彭靖[1] 袁亦铭[1] 张志超[1] 崔万寿[1] 宋卫东[1] 方冬[1] TANG Yuan;LIU Jian-jia;PENG Jing;YUAN Yi-ming;ZHANG Zhi-chao;CUI Wan-shou;SONG Wei-dong;FANG Dong(Center of Andrology,Peking University First Hospital,Beijing 100034,China;Department of Urology,Qingyuan People’s Hospital,Qingyuan,Guangdong 511500,China)

机构地区：[1]北京大学第一医院男科中心,北京100034 [2]清远市人民医院泌尿外科,广东清远511500

出　　处：《中华男科学杂志》2022年第2期140-143,共4页National Journal of Andrology

摘　　要：目的:评估既往附睾炎病史是否影响附睾梗阻患者行显微输精管附睾吻合术的术后复通和自然受孕结果。方法:选取2014年1月至2016年12月北京大学第一医院男科中心收治的205例附睾梗阻患者,全部接受了显微输精管附睾吻合术,采用纵向套叠双针吻合技术。术后每3个月进行精子质量评估直至成功受孕。比较有附睾炎和无附睾炎病史患者的术后复通率和自然受孕率。结果:患者平均年龄31(22~46)岁。163例患者完成随访,平均随访时长25.4(7~42)个月。其中有37例患者(22.2%)曾有附睾炎病史,126例患者(77.8%)无明确附睾炎病史。无附睾炎和有附睾炎病史二组患者的复通率无明显统计学差异(81.7%vs 73.0%,P=0.243)。两组中位精子浓度分别为15.2(0.8~33.4)×10^(6)/ml和18(1.3~33.60)×10^(6)/ml(P=0.710)。前向运动精子百分率分别为19.3(0~41)%和27.5(0~46.1)%(P=0.592)。两组的自然受孕率也无明显统计学差异(38.9%vs 24.3%,P=0.104)。无附睾炎患者组的总体复通率和受孕率都稍高于有附睾炎患者组。结论:显微输精管附睾吻合术是治疗各种原因导致的附睾梗阻的有效方法。既往附睾炎病史对显微输精管附睾吻合术的结果无明显影响。Objective:To evaluate the influence of epididymitis history on the results of microsurgical vasoepididymostomy and spontaneous pregnancy in patients with epididymal obstruction.Methods:Totally 205 patients with epididymal obstruction underwent microsurgical two-suture longitudinal intussusception vasoepididymostomy from January 2014 to December 2016.After surgery,we evaluated the semen quality of the patients every 3 months till conception and compared the rates of patency and spontaneous pregnancy between the patients with and those without an epididymitis history.Results:The patients ranged in age from 22 to 46(mean 31)years,37(22.2%)with and 126(77.8%)without an epididymitis history among the 163 patients for whom a 25.4-month follow-up(from 7 to 42 months)was completed.No statistically significant differences were observed postoperatively between the patients with and those without an epididymitis history in the patency rate(73.0%vs 81.7%,P=0.243),sperm concentration(18[1.3-33.6]vs 15.2[0.8-33.4]×10^(6)/ml,P=0.710),percentage of progressively motile sperm(27.5[0-46.1]%vs 19.3[0-41]%(P=0.592)or rate of spontaneous pregnancy(24.3%vs 38.9%,P=0.104).Conclusion:Microsurgical vasoepididymostomy is an effective method for the treatment of epididymal obstruction,and epididymitis history does not affect the results of the strategy.

关 键 词：附睾炎 显微手术 输精管附睾吻合 受孕 

分 类 号：R697.22[医药卫生—泌尿科学] R699.8[医药卫生—外科学]