两种TESA方法在腮腺炎致无精子症患者取精中的比较

Comparison of two methods for testicular sperm retrieval in azoospermia caused by mumps

目的探讨腮腺炎致无精症患者两种睾丸活检取精(TESA)即开放性睾丸活检和显微切割睾丸活检取精的优劣。方法每组24例患者,分别用开放性睾丸活检和显微切割睾丸活检取精,观察取精成功率、术后并发症发生率,术后并发症包括术后血肿的形成,术后3月睾丸萎缩、睾酮下降。结果开放性睾丸活检取精组,能找到活动的精子14例,取精成功率58.3%,术后并发症10例,约41.7%,分别为血肿2例、三月后睾丸萎缩3例、睾酮下降5例;显微切割睾丸活检取精组,能找到活动的精子18例,取精成功率75%,术后并发症5例,约20.8%,分别为血肿0例、三月后睾丸萎缩1例、睾酮下降4例。取精成功率和开放性睾丸活检取精组比较(P<0.05),术后并发症和开放性睾丸活检取精组比较(P<0.01)。结论显微切割睾丸活检取精较开放手术睾丸活检取精成功率高、术后并发症少,值得推广。

Objective ： To comparison of two methods for testicular sperm retrieval in azoospermia caused by mumps. Methods ： ：24 cases of azoospermic patients caused by mumps each groups for testicular sperm extraction and microdissection testicular sperm extraction. To observe the incidence of sperm obtained success rate, and Postoperative complications, postoperative complications including hematoma formation after operation, postoperative atrophy of testis and testosterone decline after 3 months. Results ： In groups of testicular sperm extraction, 14 cases can find the activity of sperm, sperm retrieval success rate was 58.3%, 10 cases were postoperative complications and the rate was 41.7%, respectively, 2 cases of hematoma, 3 cases of testicular atrophy,, 5 cases of testosterone de- creased after 3 months. In groups of microdissection testicular sperm extraction. 18 cases can find the activity of sperm, sperm retrieval success rate was 75 %, 5 cases were postoperative complications and the rate was 20. 8%, respectively, 0 cases of hematoma, 1 cases of testicular atrophy, 4 cases of testosterone decreased after 3 months. P 〈 0. 05 in sperm retrieval success rate comparison testicular sperm extraction and microdissection testicular sperm extraction and P 〈 0. 05 in postoperative complication. Conclusions ： Sperm retrieval success rate was higher and postoperative complications was less in microdissection testicular sperm extraction. Microdissection testicular sperm extraction is worthy of promotion.