显微镜下输精管附睾吻合术在男性梗阻性不育治疗中应用.docVIP

显微镜下输精管附睾吻合术在男性梗阻性不育治疗中应用 　　摘要：目的 以传统端端吻合或端侧吻合术为对照，探讨显微镜下纵向两针套叠术式治疗男性梗阻性不育症的临床效果。方法 将5 8例梗阻性不育男性患者按入院顺序分组，研究组30例患者行纵向两针套叠吻合术，对照组28例患者行传统端端或端侧吻合术。比较两组疗效及预后。结果 研究组复通成功率80%和受孕成功率14.3%明显高于对照组，梗阻复发率3.3%明显低于对照组21.4%，数据经比较差异具有统计学意义，（P0.05）。结论 显微镜下输精管附睾吻合术治疗男性梗阻性不育症具有有效性和安全性，有利于提高复通率和受孕率，减少梗阻复发，适合于临床推广应用。 　　关键词：显微镜，输精管附睾吻合术，梗阻性不育症，疗效观察 　　Application of Microscopic Vasoepididymostomy in Male Obstructive Infertility Treatment 　　XIONG Zheng-yu 　　(Zhangjiajie City Peoples Hospital,Zhangjiajie 427000,Hunan,China) 　　Abstract：ObjectiveTo traditional end to end anastomosis or end side anastomosis for comparison, under microscope longitudinal two nested the clinical effect of surgical treatment of male obstructive infertility. Methods8 cases of obstructive infertility male patients in hospital order 5 groups, group of 30 patients with vertical line two nested anastomosis, 28 cases in the control group patients traditional end to end anastomosis or client side. Compare two groups of curative effect and prognosis. Results the team after the success rate of 80% and 14.3% pregnancy rates significantly higher than the control group, the obstruction the recurrence rate 3.3% to 21.4%, significantly lower than the control group data by comparing differences statistically significant (P0.05). ConclusionThe microscopic vas deferens epididymis anastomosis male obstructive infertility treatment has the efficacy and safety, to improve after rate and conception rate, reduce the recurrence of obstruction, is suitable for clinical application. 　　Key words：Microscope;Vas deferens epididymis anastomosis;Obstructive infertility;Curative effect observation 　　 　　据统计全球的不育症发病率约为10%，其中男性因素出现的不育为50%[1]。梗阻性不育在男性不育患者中比例为10%~15%[2]，尤以附睾梗阻最为多见。输精管附睾吻合术是解除梗阻的较好手段，本文以传统端端吻合或端侧吻合术为对照，探讨显微镜下纵向两针套叠术式的临床效果，现总结报道如下。 　　1资料与方法 　　1．1一般资料患者58例，为我院2011年1月~2013年12月诊断为梗阻性不育症病例，均为男性，婚后不育1年以上，且患者配偶均经我院妇科检查确定生育功能正常。受试男性患者经3次以上精液检测，确定精子排出数量为零，附睾经皮穿刺取活组织样本化验，结果可见精子，行精浆果糖定性试验结果为阳性。患者年龄23~35岁，平均（29.6±4.2）岁；梗阻部位：输精管近附睾端2