梗阻性无精子症的外科治疗
【摘要】 目的 探讨梗阻性无精子症的外科治疗方法及效果。 方法 对30例梗阻性无精子症患者,根据其病因分别采取输精管输精管吻合术、输精管附睾管吻合术、输精管输精管吻合术加对侧输精管附睾管吻合术。术后6 mo及1 a末检查患者精子的排出情况,并比较3组手术的效果。 结果 术后6 mo末患者精子出现率73%,精子正常率40%;29%的患者精子运动率>30%;输精管端端吻合术后精子出现率62%,输精管附睾吻合术后精子出现率40%,两组比较差异有极显著性(P<0.01)。 结论 梗阻性无精子症的外科治疗方法简便、经济,效果较好。
【Abstract】 Objective To explore surgical treatments and results for obstructive azoospermatism. Methods According to etiopathogenisis, 30 patients with obstructive azoospermatism were given vasovasostomy,vasoepididymostomy or vasovasostomy plus opposite vasoepididymostong,respectively. At the ends of the 6th and 12th month after operation, spermatic discharge were checked up and operative results compared among the 3 groups.Results At the end of the 6th month, spermatic frequency was 73% and normal sperm rate 40%; sperm movement rate of 29% patients was >30%; spermatic frequency after vasoepidi EEAn was 62% and after vasoepididymostomy 40%, there was very significant difference between the 2 groups(P0.01). Conclusion Surgical treatments of obstructive azoospermia are convenient and economical and has better effects.
【Keywords】 Obstructive azoospermatism;surgical treatment; curative effect 无精子症(Azoospermia)是指射出的精液中没有精子。为探讨梗阻性无精子症的外科治疗方法及效果,我们采用外科手术治疗进行了相关研究,现报告如下。
1 对象与方法。
1.1 对象 选取2000年1月~2006年1月在我院门诊经输精管造影检查诊断为梗阻性无精子症的30例患者为研究对象。年龄24 a~51 a。
1.2 方法 采用利多卡因局部麻醉或腰麻下进行手术,常规佩带手术放大眼镜,在放大4倍野下操作。其中术式采用输精管端端吻合术17例;输精管附睾吻合术11例;混合方法(单侧输精管吻合术、对侧输精管附睾管吻合术)吻合术2例。具体吻合方法:所有病例均采用9~0号无损伤缝合线,在插入临时支架下用二定点缝合法一层缝合管壁。吻合部位稍加缝合固定。同时分析梗阻性无精子症的病因。
2 结果。
2.3 术后精子出现率 术后6 mo末22例(73%)排出精子。其中精子正常12例(40%),29%的患者精子运动率>30%。术后1 a末,10例少精症中度,1例恶化为无精子。