梗阻性无精子症显微外科重建策略分析
Strategic analysis of microsurgical treatment to obstructive azoospermia

目的 ·探讨梗阻性无精子症显微外科重建策略。方法 ·以182例梗阻性无精子症手术患者为研究对象。首先行输精管道探查，根据术中探查情况行输精管道显微重建术。结果 ·术中探查证实附睾梗阻86例，输精管梗阻30例，先天性双侧输精管精囊缺如48例，睾丸网梗阻1例，射精管梗阻17例；探查后行显微重建吻合术114例。术后患者共随访92例，平均随访时间9个月（3～16个月）。术后复通率为71.7%（66/92），自然受孕率为32.6%（29/89），其中3例未婚。结论 ·梗阻性无精子症梗阻原因复杂,梗阻部位多变，可根据术前严格评估和术中探查行显微复通手术，进而获得自然妊娠的机会。
： Objective · To investigate the strategy of microsurgical treatment to obstructive azoospermia (OA). Methods · There were totally 182 OA patients received surgical treatments. Various patients were preformed various microsurgical treatment. Results · Among the 182 patients, 86 patients had epididymal obstruction. Other etiologies included vasal obstruction in 30 cases, congenital bilateral absence of vas deferens in 48 cases, ejaculatory duct obstruction in 17 cases, obstruction of rete testis in 1 case. 114 patients were performed microsurgery, 92 cases were followed up. The mean follow-up period was 9 months (3-16 months). The patent rate was 71.7% (66/92), the natural pregnant rate was 32.6% (29/89). Conclusion · For the obstructive azoospermia, the etiology and the obstructive site is multiform, microsurgery is the first choice, various patients can be preformed various treatment. The microsurgery techniques in OA treatments have an obvious advantage, especially for the chance for achieving natural pregnancy