射精管梗阻性无精症经直肠高频超声检查临床资料分析-analysis of clinical data of high frequency transrectal ultrasonography for obstructive azoospermia of ejaculatory duct.docxVIP

中文摘要目的：探讨经直肠高频超声检查在射精管梗阻性无精症诊断中的临床价值。方法：回顾性分析经直肠高频超声检查高度怀疑梗阻性无精子症患者293例的临床资料，参照WHO《WHO人类精液及精子一宫颈粘液相互作用实验室检验手册》第4版的诊断标准符合梗阻性无精子症的标准，疑似患者均经过一系列临床与实验室检查包括体检，精液分析，精浆生化，血清性激素检测后，所有患者均给予经直肠高频超声检查。结果：经直肠高频超声检查射精管梗阻性无精子症患者54例中，均表现出异常的超声影像，且表现多样，有射精管扩张直径，精囊扩张，精阜内、射精管钙化以及近中线或偏离中线处有囊肿等表现并且多种影像学变现常伴发存在。结论：经直肠高频超声检查技术可作为筛选射精管梗阻性无精症的首选方法，具有安全、无创的特点，值得临床推广应用。关键词：经直肠高频超声检查；射精管梗阻；梗阻性无精子症；EjaculatoryDuctObstructiveAzoospermiaTransrectalUltrasoundFrequencyofClinicalDataAbstractObjective：Toevaluatetransrectalultrasonographyinejaculatoryfrequencyofobstructiveazoospermiadiagnosisofclinicalvalue.Methods：Aretrospectiveanalysisoftransrectalhigh-frequencyultrasoundhighlysuspectedinpatientswithobstructiveazoospermia，clinicaldataof293cases，withreferenceto《WHOofhumansemenandspermcervicalmucusinteractionbetweenalaboratoryManual》4theditionofthediagnosticcriteriaconsistentwithObstructiveazoospermiastandards，suspectedpatientshavetoundergoaseriesofclinicalandlaboratoryexamination，includingphysicalexamination，semenanalysisandseminalplasmabiochemistry，serumsexhormonetesting，allpatientsweretreatedwithtransrectalhigh-frequencyultrasound.Results：Transrectalhigh-frequencyultrasoundejaculatoryductobstructionazoospermiain54patients，haveshownabnormalB-image.Andperformancevaried，withejaculatoryductexpansiondiameter，seminalvesicleexpansion，colliculusurethralis，theejaculatoryductcalcification，andnearthecenterlineorthedeviationfromthemidline，andtheperformanceofacyst，oftenaccompaniedbymultipleimagingrealizedthere.Conclusion：Transrectalhigh-frequencyultrasounddiagnosisofejaculatoryductobstructionandtechnologyasazoospermiapreferredmethodissafe，non-invasivefeatures，worthyofclinicalapplication.Keywords：Transrectalhigh-frequencyultrasound;ejaculatoryductobstruction;obstructiveazoospermia引言近年来男性不育的发病率逐渐升高，而无精子症是男性不育症中较为严重的病因之一，发病率约为10%[1]。其中男性不育占不育因素的40%，而无精子症在男性不育患者中约占10%～30%[2-5]，是目前男性不育的较大诊治难题。无精子症是指射出的精液经离心沉淀后经显微镜观察，连续3次均未发现精子。无精子症分为精子通路梗阻或缺如导致的梗阻性无精子症和精子发生障碍导致的非梗阻性无精子症[6-7]。无精子症准确合理的选择应用诊断治疗技术是进行整个诊疗过程的关键问题[8]。探讨无