摘要
目的:初步评估国内目前睾丸活检手术和睾丸病理对梗阻性无精子症的诊断价值。方法:对曾接受过睾丸活检经本次临床诊断为梗阻性无精子症的84例梗阻性无精子症患者进行梗阻病因分析,对病理报告无精子者重新进行经皮细针附睾或睾丸穿刺(PESA或TEFNA)检查,并对先前的睾丸病理报告进行分析。结果:84例均诊断出明确的梗阻病因,其中先天性梗阻56例(66.67%);炎症性梗阻26例(30.95%);另2例为双侧疝气术史。对33例递交的病理报告为无精子者中的29例重新进行PESA或TEFNA手术,均获取了附睾或睾丸精子。84例中的57例行ICSI62个周期,周期妊娠率为46.8%。结论:本组患者的病因主要为先天性或炎症性梗阻,目前国内睾丸病理学对梗阻性无精子症睾丸内是否存在精子的诊断欠准确。对梗阻性无精子症患者可应用损伤小的PESA或TEFNA进行诊断,有利于患者的后续治疗。
Objective： To primary evaluate the diagnosis values of the testicular biopsy and pathological analysis of testicular tissue as a means for obstructive azoospermia. Methods： Totally 84 patients who had previously undergone a testicular biopsy and pathological analysis were recruited for this study. After a clinical re-evaluation, the diagnosis of obstructive azoospermia and the etiology of each patient＇ s disease were obtained. The patients who had no spermatozoa retrieved via the previous biopsy were then subjected to either a percutaneous epididymal sperm aspiration （PESA） procedure or a testicular fine needle aspiration （TEFNA） procedure. Results： Out of 84 patients with OA, 56 （66.67%） cases were congenital, 26 （30.95%） cases were inflammatory, 2 cases had a history of bilateral herniotomy. Out of 33 cases whose pathological analysis failed to retrieve any spermatozoa, the spermatozoa could be retrieved in all 29 cases after the second procedure （PESA or TEFNA）. ICSI was performed for 57 cases with 62 cycles, and the pregnancy rate was 46.8%. Conclusion： The testicular biopsy and pathological analysis has a high false-negative rate and is not sensitive enough to be a good diagnostic test for OA, and PESA or TEFNA with less trauma is benifit for further treatment.
出处
《生殖与避孕》
CAS
CSCD
北大核心
2009年第7期466-470,共5页
Reproduction and Contraception
基金
交通大学医学院科技基金项目,项目号:06XJ21101
