保留精索内动脉的精索静脉结扎术治疗严重少精子症不育患者的疗效  

Effect of preservation artery spermatic internal of spermatic vein ligation in infertile patients with severe oligospermatism

作　　者：秦红平 吕爱霞 李亚丽 阎一鑫 王玲[1] QIN Hongping;LYU Aixia;LI Yali;YAN Yixin;WANG Ling(Reproductive Medicine Center,the 940th Hospital of Joint Logistics Support Force of Chinese PLA,Lanzhou 730050,Gansu,China)

机构地区：[1]中国人民解放军联勤保障部队第九四○医院生殖医学中心,兰州730050

出　　处：《中国性科学》2022年第11期34-37,共4页Chinese Journal of Human Sexuality

基　　金：军队计划生育专项(20JSZ09);甘肃省青年科技基金计划项目(21JR1RA188)。

摘　　要：目的评估严重少精子症合并精索静脉曲张的不育患者行精索静脉结扎术的临床效果,并比较精索内动脉(ASI)保留与结扎的近期与远期疗效。方法选取2017年6月至2020年6月中国人民解放军联勤保障部队第九四○医院生殖医学中心收治的160例Ⅱ/Ⅲ级精索静脉曲张合并严重少精子症的不育患者作为研究对象。随机分为试验组和对照组,每组80例。试验组行保留ASI的精索静脉结扎术,对照组行结扎ASI的精索静脉结扎术。观察并比较两组术前、术后6个月的精液指标及睾丸体积;术后12个月,采用Logistic单因素和多因素分析影响自然妊娠率的相关因素。结果术后6个月,试验组精液指标优于对照组,差异具有统计学意义(P<0.05);两组睾丸体积比较,差异无统计学意义(P>0.05)。术后12个月,两组共52例(35.4%)自然妊娠;双侧精索静脉曲张、精子总活力≤18%、行ASI结扎的精索静脉结扎术是导致患者自然妊娠率降低的独立危险因素(P<0.05)。结论严重少精子症合并精索静脉曲张的不育患者行保留ASI的精索静脉结扎术,有助于提升其的自然妊娠率。Objective To evaluate the efficacy of spermatic vein ligation in infertile patients with severe oligospermia and varicocele,and to compare the short-term and long-term effects of preservation and ligation of the artery spermatic internal(ASI).Methods 160 infertile patients with grade Ⅱ/Ⅲ varicocele and severe hypospermia attending the Reproductive Medicine Center,the 940 th Hospital of Joint Logistics Support Force of Chinese PLA from June 2017 and June 2020 were selected as the research objects.They were randomly divided into experimental group and control group,with 80 patients in each group.The preservation of ASI of spermatic vein ligation was performed in the experimental group,while the ligation of ASI of spermatic vein ligation was performed in the control Group.At preoperative and 6 months postoperative,the semen parameters and testicular volume were observed and compared between the two groups.At 12 months postoperatively,factors associated with the natural pregnancy rate were analyzed using Logistic univariate and multivariate analysis.Results At 6 months postoperative,semen parameters were better in the experimental group than in the control group;there was no significant difference in testicular volume between the two groups(P>0.05).At 12 months postoperatively,52 patients(35.4%)were spontaneously pregnant in both groups.Bilateral varicocele,total spermatozoal activity≤18% and ligation of ASI of spermatic vein ligation was an independent risk factor for a decrease in the rate of natural pregnancy(P<0.05).Conclusions Preservation of ASI of spermatic vein ligation is helpful in increasing the natural pregnancy rate in these infertile patients with severe oligospermia and varicoceles.

关 键 词：不育 少精症 精索内动脉 精索静脉结扎术 

分 类 号：R697[医药卫生—泌尿科学]