40例输精管道梗阻性无精子症诊疗策略分析

发布时间：2018-01-11 15:04

本文关键词：40例输精管道梗阻性无精子症诊疗策略分析　出处：《生殖与避孕》2015年02期 　论文类型：期刊论文

【摘要】：目的:探讨输精管道梗阻性无精子症(OA)的诊疗策略。方法:40例输精管道OA患者为研究对象。首先行输精管道探查,根据术中探查情况行输精管-输精管显微吻合术(VV)、输精管-附睾显微吻合术(VE)、交叉输精管-输精管吻合术、交叉输精管-附睾管显微吻合术或睾丸取精冻存术。结果:精道探查后,共行吻合手术26例,取精+冻精手术14例。40例患者中,共有3例患者失访(2例吻合患者,1例冻精患者)。随访到的24例吻合术患者术后复通率为58.3%(14/24),自然受孕率为29.1%(7/24)。随访到的13例取精+冻精患者中已有11例行ICSI/冻精助孕。结论:输精管道OA,可根据术前严格评估和术中探查行显微复通手术或取精术;复通术后可获得自然妊娠的机会,交叉显微吻合为输精管道复通的有效途径之一。
[Abstract]:Objective: to investigate the diagnosis and treatment strategy of vasectomy with obstructive azoospermia (OAA). Methods: 40 patients with OA of vas deferens were studied. According to the intraoperative exploration, vas deferens-vas deferens microanastomosis (VVV), vas deferens epididymis microanastomosis (VAS), cross vas deferens-vas deferens anastomosis were performed. Results: there were 26 cases of spermatozoa anastomosis after exploration of spermatozoa and 14 cases of spermatozoa extraction. A total of 3 cases were lost and 2 cases were anastomosed with 1 case of frozen spermatozoa. The postoperative recanalization rate of 24 cases of anastomosis was 58.3% (14 / 24). The rate of spontaneous pregnancy was 29.1g / 24%. ICSI / frozen spermatozoa was performed in 11 of the 13 patients followed up. Conclusion: the vasovasal duct OA. According to preoperative strict evaluation and intraoperative exploration, microsurgery or spermatectomy can be performed. The opportunity of spontaneous pregnancy can be obtained after recanalization, and cross-microanastomosis is one of the effective ways to recuperate the vas deferens.
【作者单位】：上海交通大学医学院附属仁济医院泌尿外科;上海市男科学研究所;上海市人类精子库;上海交通大学医学院附属仁济医院生殖医学中心上海市辅助生殖与优生重点实验室;上海市生殖医学重点实验室;
【基金】：上海市市级医院适宜技术项目(SHDC12014263)
【分类号】：R698.2
【正文快照】： 发展,患者希望显微术后获得自然妊娠,而且显微外科精道再通具有更高的成本效益。腹股沟区手术或合并其他因素的输精管道OA,仍有机会通过显微外科治疗恢复精道通畅,获得自然生育[3]。附睾是临床最常见的梗阻部位,备受临床医师关注。对输精管道梗阻的无精子症,诊疗方案的优化亦

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