摘要
目的分别应用经阴囊及直肠腔内彩色多普勒超声进行无精子症的精确诊断分型,探讨两者在分型中的价值。方法收集2010年1月至2013年6月于中山大学附属第三医院就诊且临床初步诊断为无精子症的男性不育症患者496例,所有患者均行经阴囊及经直肠腔内彩色多普勒超声检查。根据文献资料及临床特点,我们提出无精子症的6种分型:Ⅰ型,超声检查均未见异常;Ⅱ型,睾丸源性病变引起的非梗阻性无精子症;Ⅲ型,输精管道先天畸形所致梗阻性无精子症;Ⅳ型,其他病变可疑与梗阻性无精子症相关;Ⅴ型,混合型,同时存在非梗阻及梗阻原因;Ⅵ型,精索静脉曲张。结果Ⅰ型,19例;Ⅱ型,睾丸体积<10 ml,63例;Ⅲ型,235例,其中附睾缺如30例,输精管缺如76例,精囊缺如59例,精囊萎小或发育不良20例,输精管缺如并精囊缺如38例,附睾、输精管及精囊均缺如12例;Ⅳ型,87例,其中附睾头囊肿16例,精囊囊肿5例,前列腺中部囊肿41例,附睾炎7例,输精管钙化5例,精囊钙化13例;Ⅴ型,6例;Ⅵ型,86例。结论结合经阴囊高频及经直肠腔内彩色多普勒超声行无精子症的精确诊断分型,其中Ⅱ型、Ⅲ型及Ⅵ型超声能相对明确诊断。
Objective To investigate the typing diagnosis ofazoospermia with scrotal and transrectal ultrasonography. Methods From Jan. 2010 to Jun.2013, 496 infertile men were diagnosis azoospermia in the Third Affiliated Hospital, Sun Yat-sen University. All patients underwent scrotal and transrectal ultrasound examination. Depending on literatures and clinical requirement, we supposed that azoospermia ultrasonic diagnosis were classified into six types. Type Ⅰ ： none abnormal founds in scrotal and transrectal ultrasonography; Type Ⅱ ： nonobstructive azoospermia because of pathological genital duct; Type Ⅲ： obstructive azoospermia because of congenital deformities of vas deferens; Typeiv ： other diseases may be connection with obstructive azoospermia; Type Ⅴ ： mixed type, both nonobstructive and obstructive etiological factor existence; TypeⅥ ： scrotal varicocele.Results Type Ⅰ ：19 cases were found none abnormal in scrotal and transrectal ultrasound examination. Type Ⅱ ： 63 cases with low semen volume were diagnose nonobstructive azoospemfia. Type Ⅲ： total 235 cases, congenital absence of the epididymis in 30 cases, congenital absence of the vas deferens in 76 cases, congenital absence of the seminal vesicles in 59 cases, hypogenesis of seminal vesicles in 20 cases, congenital absence of the vas deferens and seminal vesicles in 38 cases, while congenital absence of all the epididymis, vas deferens and seminal vesicles in 12 cases. Type Ⅳ： total 87 cases, included 16 cases of cysts in head of epididymis, 5 cases with seminal cysts, 41 cases with cysts in prostate, 7 cases with epididymitis, 5 cases with calcification in vas deferens, 13 cases withcalcification in seminal vescicle. Type V ： 6 cases with mixed type. Type Ⅵ ： 86 cases with varicocele. Conclusions Typing diagnosis of azoospermia combining with scrotal and transrectal ultrasonography could provide exact diagnosis in type Ⅱ, typeⅢ, and typeⅥ.
出处
《中华腔镜泌尿外科杂志（电子版）》
2015年第1期50-53,共4页
Chinese Journal of Endourology(Electronic Edition)
