输精管再通术治疗中长期附睾淤积症的临床观察

Clinical Research on the Effect of Redo Vasovasostomy on the Medium-and Long-term Epididymal Stasis Symptom

目的:观察输精管再通术对中长期附睾淤积症的治疗效果,指导合理应用手术治疗中长期附睾淤积症。方法:对82例中长期附睾淤积症行输精管再通术者进行回顾性分析,通过观察附睾淤积程度、淤积时间、合并症、手术效果来评价疗效。结果:手术有效率轻度附睾淤积100%、中度附睾淤积50%,输精管再通术无效者行附睾切除术的有效率为17%(2/12),其中80%(10/12)术前患有神经衰弱、焦虑症。结论:输精管再通术在中长期附睾淤积症的治疗效果肯定,严格排除心身疾病及评估术前并存疾病对附睾淤积症的影响,有助于提高输精管再通术治疗中长期附睾淤积症的效果。

Objective：To observe the effect of redo vasovasostomy on the medium-and long-term epididymal stasis symptom in order to provide the guidance on rational use of surgical treatment. Methods：A retrospective analysis on 82 patients who underwent redo vasovasostomy for treatment of the medium-and long-term epididymal stasis symptom was conducted. The effectiveness of reoperation was evaluated according to the degree and the duration of epididymal stasis as well as complications. Results： The effective rate was 100% and 50% in the patients with mild and moderate epididymal stasis respectively. Seventeen percent of patients was cured by epididymectomy after failed redo vasovasostomy,80% of whom suffered from neurasthenia and anxiety before operation. Conclusion： Redo vasovasostomy may be effective in the treatment of the medium and longterm epididymal stasis symptom. The physical and mental diseases should be ruled out strictly and the effect of the complications on epididymal stasis symptom should be evaluated,which will contribute to improve the effectiveness of redo vasovasostomy on the medium-and long-term epididymal stasis symptom Study on the Correlation of Neurological Disease and Serum Vitamin B12 Concentration in the Second and Third TrimesterSu Guifang,Zhao Dexiong,Wang Rui,et al. Department of Obstetric and Gynecology,Red Cross Hospital of Qinghai,Xining 810000 Objective：To explore the correlation of neurological disease and serum vitamin B12 concentrations in the second and third trimester in order to find out the clinical effect of vitamin B12 supplement. Methods： A case control study was conducted. Sixty pregnant women with severe and slight symptom of neurological dysfunction were allocated to group Ⅰand group Ⅱ respectively according to the severity of symptom. And the control group （group Ⅲ） included 30 normal pregnant women. Women in group Ⅰand group Ⅱreceived vitamin B12 intramuscularly and orally respectively. The concentrations of serum vitamin B12 were determined by chemiluminescence immunoassay. Results： The concentrations of vitamin B12 were 98.7±37.8 pmol/L and 158.9±46.8 pmol/L in groupⅠand group Ⅱrespectively,significantly lower than that in group Ⅲ （334.4±109.3 pmol/L,P0.05）. The concentration of vitamin B12 in patients after treatment were 289.7±44.4 pmol/L and 212.5±48.1 pmol/L in groupⅠand groupⅡrespectively. In these two groups,statistically significant differences were found before and after treatment （ P 0.05）. As to the neurological symptom,86.67% patients in group Ⅰ and 63.33% in group Ⅱ were relieved. Significant difference was found between groupⅠand groupⅡ. Conclusion： The occurrence of neurological symptom could be related to the decrease of serum vitamin B12 concentration in the second and third trimester. Vitamin B12 supplement is necessary for the treatment of Vitamin B12 deficiency in the second and third trimester.