先天性输精管缺如患者生育问题的研究

Treatment of congenital defect of vas deferens

自1988年至1991年共收治25例先天性输精管缺如患者,在20例行手术诊治术中15例用自体睾丸精索鞘膜制成人工精池囊,5例又在囊内放置用微涤纶制成的异质管。术中抽吸10例附睾内精子进行快速活化,其中5例活化成功,行人工授精,结果2例怀孕,1例已生育一女孩。认为该症是有生育可能的,但需要解决3个问题:(1)采用显微外科技术把附睾内部活着的精子取出一定数量;(2)选配好快速活化剂使精子快速活化成功;(3)用患者的精浆培养自己的精子。建议对梗阻性无精子症在用手术疏通精路的同时可以采用快速活化精子技术行人工授精,以提高生育的效果。

Twenty five cases of congenital defect of vas deferens were treated in 1988 to 1990. An operation of artificial seminal vesicle by using the patient's common sheath of testis and spermatic cord or by inserting a tube made of micropolyester fibre inside the seminal vesicle were performed in 20 cases. During the operation sperms from the caput epididymis were aspirated in 10 cases and were quickly activated. In 5 cases artificial insemination with the activated sperms resulted in 2 pregnancies with 1 delivery a girl. The authors suggested that it is possible for cases with congenital defect of vas deferens to become fertile if the following processes-can be done: (1) to obtain certain amount of living sperms from caput epididymis with microsurgical technique, (2)select reagents to activate the sperms, (3) culture the sperms with the patient's own semen plasma. In cases of obstructive azoospermia artificial insemination can be performed while trying to free the obstruction with surgical method.