摘要
对经常规输精管吻合1次未复通的9例,2次仍未复通的6例以显微外科技术施行了再次输精管吻合术。后获精液复查的14例均再现精子,复通率达100％。这15例在本次吻合术前检查血清精子凝集抗体有80％为阳性,术中取输精管结节病检有16.7％发现精子肉芽肿。吻合术采用4定点全层缝合后先将两侧壁打结,然后间针浆肌层缝合前后壁再打结,这样缝合方便准确,对合严整。术中检查近睾端输精管精子采用消毒玻片直接沾涂溢液、附睾及输精管曲段按摩,生理盐水低压灌注等方法使精子检出率达80％。
Microsurgical vasal reanastomosis was carried out in 9 patients failured in routine vasovasostomy and 6 patients failured in reanastomosis. Spermatozoa reappeared in 14 cases who gained semen analysis after surgery, the reverse rate was 100 percent. The key technique of reanastomosis was total layer suture applied on 4 points, tied the two sutures of two side wall first, then interrupted seromuscular sutures were applied between four points and tied altogether. The vas fluid may be obtained by massaging and pcefusing epididymis and flexure of vas deferens in order to make sure spermatozoa was appeared at least in 80％ of the cases.
