睾丸固定钳固定法在经皮附睾穿刺取精术中的应用价值

发布时间：2018-06-30 07:52

  本文选题：睾丸固定 + 睾丸固定钳　； 参考：《中华生殖与避孕杂志》2017年04期

【摘要】：目的评价睾丸固定钳固定法在经皮附睾穿刺取精术(PESA)中的应用价值。方法选取初步诊断为梗阻性无精子症患者532例,将其随机分为三指固定法组(249例)和睾丸固定钳组(283例),比较两组PESA穿刺精子获取率差异。另根据经阴囊超声附睾头有无扩张以及扩张特征将病例分为附睾头细网状扩张亚组、附睾头管状/多囊管状扩张亚组和附睾头无扩张亚组,比较两种PESA方法对不同附睾头病变穿刺精子获取率的差异。结果三指固定法组穿刺精子获取率为60.64%(151/249),睾丸固定钳组为74.56%(211/283),显著高于三指固定法组(P0.05)。睾丸固定钳组穿刺精子获取率的优势主要由细网状扩张组贡献,该组三指固定法穿刺精子获取率为72.67%(125/172),而睾丸固定钳法为89.90%(178/198),显著高于三指固定法组(P0.05)。管状/多囊管状扩张亚组以及附睾头无扩张亚组2种PESA法穿刺精子获取率都偏低,差异无统计学意义(P0.05)。结论使用睾丸固定钳固定法对附睾头细网状扩张的患者进行PESA穿刺能提高精子获取率。
[Abstract]:Objective to evaluate the value of testicular fixator fixation in percutaneous epididymal sperm extraction (PESA). Methods 532 patients with obstructive azoospermia were randomly divided into three finger fixation group (249 cases) and testis fixation forceps group (283 cases). According to the characteristics of dilatation and dilatation of the head of epididymis via scrotal ultrasound, the patients were divided into three groups: the head of epididymis with fine reticular dilatation, the tubular / polycystic head of epididymis and the head of epididymis without dilatation. To compare the difference between two PESA methods in obtaining sperm from different epididymal lesions. Results the rate of sperm acquisition was 60.64% (151 / 249) in the three-finger fixation group and 74.56% (211 / 283) in the testicular fixator group, which was significantly higher than that in the three-finger fixation group (P0.05). The advantages of testicular fixation forceps were mainly contributed by fine reticular dilatation group. The rate of spermatozoa obtained by three-finger fixation was 72.67% (125 / 172), while that of testicular fixation was 89.90% (178 / 198), which was significantly higher than that of three-finger fixation group (P0.05). In tubular / polycystic tubular dilatation subgroup and epididymal head without dilated subgroup, the rate of spermatozoa obtained by two kinds of PESA methods was lower than that of the control group (P0.05). Conclusion using testicular fixator fixation in patients with fine reticular dilatation of epididymis can improve the rate of spermatozoa.
【作者单位】： 广西医科大学第一附属医院男性科;
【分类号】：R698.2

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