预防输精管结扎术后并发症的体会

<正> 输精管结扎术是比较理想的节育手术。但手术要求无菌操作严格,操作过程必须熟练细致,任何一个环节的疏忽,都会使并发症发生率明显增加。提高手术质量,防止并发症发生是医务人员必须高度重视的问题。减少并发症的发生率关健在于预防。以下是本人20多年来手术中的一点体会。 一、资料 据对2829例输精管结扎术后随访统计,属并发     

家兔输精管结扎合睾丸雄激素受体mRNA表达及与血浆睾酮变化关系…

３０只日本大耳白雄兔，分为输精管结扎２５月组和假手术２５月组，输精管疆扎６月组和假手术６月组。应用放射免疫技术测定血浆睾酮含量；应用大鼠雄激素受体ｃＤＮＡ探针，Ｎｏｒｔｈｅｒｎ杂交方法检测睾丸组织的ＡＲｍＲＮＡ表达，分析输精管结扎对睾丸ＡＲｍＲＮＡ表达强度的影响。     

Tamoxifen induced multinucleated cells （symplasts） and distortion of seminiferous tubules in rat testis

Aim: To evaluate the effect of tamoxifen citrate on male reproductive system of rat. Methods: Groups of male rats were gavaged with tamoxifen at doses of 200 mg·kg-1·d-1, 400 mg·kg-1·d-1 or 800 mg·kg-1·d-1 in 0.1 mL olive oil for 10 consecutive days. Controls were treated with 0.1 mL olive oil. Rats were anesthetized and killed on d 3, d 15 or d 35 after the last dose. Testes were collected, processed for paraffin embedding, sectioned at 5 μm thickness, stained with H&E and analyzed microscopically. Results: There was a dose-dependent increase in the occurrence of seminiferous tubular distortion with germinal cell sloughing. The highest dose increased the number of multinucleated giant cells on d 3 and d 15. Conclusion: Tamoxifen citrate induces multinucleated giant cells and germinal epithelial sloughing in a dose-dependent manner and these changes are detrimental to male fertility.     

Effect of nitrofurazone on the reproductive organs in adult male mice

Aim: To study the effect of 5-nitro-2-furaldehyde semicarbazone (nitrofurazone), a derivative of nitrofuran, on male reproductive organs of Parkes (P) strain mice. Methods: Mice were given nitrofurazone orally at a dose of 64mg/kg body weight per day, for 10 and 20 days, and were killed 24 h and/or 56 days after the last treatment. Histological appearance of testis, motility and number of spermatozoa in cauda epididymidis, and biochemical indices in epididymis and seminal vesicle were evaluated. Results: Histologically, testis showed marked regressive changes in the seminiferous tubules in mice treated with nitrofurazone. Ten days after treatment, there was much depletion of germ cells in the seminiferous tubules, and the germinal epithelium was lined mainly with Sertoli cells, spermatogonia, spermatocytes, and a few round spermatids; intraepithelial vacuoles and multinucleated giant cells were also observed in tubules. By 20 days, regressive changes in the seminiferous tubules were further pronounced, and pachytene spennatocytes were the most advanced germ cells noticed in the tubules. In severe cases, the tubules were lined with a thin layer of Sertoli cells and spermatogonia. The treatment also caused marked reductions in the motility and number of spermatozoa in the cauda epididymidis, in weight and the level of fructose in the seminal vesicle, and in sialic acid level in the epididymis. Fifty six days after drug withdrawal, the alterations induced in the reproductive organs returned to control levels. Conclusion: Our results suggest that nitrofurazone treatment in P mice induces marked alterations in the male reproductive organs, and that the alterations are reversible following cessation of treatment.     

腹股沟疝修补术致双侧输精管梗阻的临床研究

目的:探查腹股沟疝修补术导致输精管梗阻的原因及输精管再通的可复性。方法:做患者双侧输精管造影确定梗阻部位,并对患侧行手术探查及通液。结果:输精管造影显示双侧输精管显影至耻骨联合上方两侧,探查术中可见右侧腹股沟管中段近睾端输精管断端,输精管远端消失;对左侧腹股沟管内环口处输精管局部狭窄的可疑梗阻部位进行穿刺,用6号平针头加压突破输精管狭窄梗阻部位,有明显突破感。然后行输精管注水通畅试验,再向睾丸方向输精管穿刺抽取精液化验可见成活精子。结论:输精管断离和手术钳夹输精管损伤,是腹股沟疝修补术导致输精管梗阻的两种原因,再通治疗困难。而采用针头穿刺疏通法时未放置导丝,易引发术后输精管管腔粘连导致再次梗阻。     

精索静脉曲张偏爱左侧

精索是睾丸上方呈条索样的组织，在体表就可以清楚地摸到。精索是个“大家庭”，由进出睾丸的静脉、动脉、神经、淋巴管、输精管等条索样器官组成。精索静脉曲张是指精索内的静脉因血液流通不畅，瘀积于静脉血管内，长此以往，导致静脉弯曲而扩张，更加重了流通不畅，血液瘀积，形成恶性循环。     

输精管分离钳钝性分离在睾丸活检中的应用

目的 探索输精管分离钳钝性分离在睾丸活检中的应用价值.方法 选择82例无精子症患者,要求睾丸体积≥8 mL,FSH≤30 U·L-1,在精索阻滞下采用输精管分离钳钝性分离进行睾丸活检,所取得睾丸组织,若有精子则冷冻备行辅助助育,若无精子则送病理检查评估生精功能.结果 所有患者均取得1~3 mm3睾丸组织,无明显痛感,出血少,术后无不适,有精子者38例(46.34%),病理检查提示有生精细胞者37例(45.12%),唯支持细胞综合征7例(8.54%).结论 输精管分离钳钝性分离应用于睾丸活检安全、有效、简便、微创,可以作为睾丸活检的一种手段.