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目的:对无精子症流程化诊疗方式的效果进行分析讨论。方法:选择我院2011年9月-2013年9月间200例无精子症患者,所有患者均采用流程化治疗,并对患者的治疗效果进行分析。结果:71例梗阻患者10例接受手术治疗,其中有5例患者在治疗后3个月发现精液中存在精子;另有5例患者在治疗后半年发现精液中存在精子;其余61例患者均放弃手术直接要求辅助生殖技术(ART)助孕,行经皮附睾精子抽吸术/经皮睾丸精子抽取术—卵胞浆内单精子注射技术(PESA/TESE-ICSI)。129例特发性无精子症患者有113例接受药物治疗,其中有74例患者在治疗后三个月睾丸体积增大,血清卵泡生成激素(FSH)水平增高;7例患者治疗后3个月精液中发现精子;7例患者坚持治疗半年后精液中发现精子。32例患者选择供精人工授精(AID)他精法助孕,1例治疗中失访。结论:梗阻性无精子症患者可采用手术或辅助生殖进行治疗,特发性无精子症患者应该进行系统的药物治疗,并对患者进行一定时间段的观察,若治疗无效则考虑AID疗法等。
Objective: To analyze and discuss the effect of the process of azoospermia diagnosis and treatment. Methods: A total of 200 patients with azoospermia were selected from September 2011 to September 2013 in our hospital. All the patients were treated by flow cytometry, and the therapeutic effect was analyzed. RESULTS: Seventy-one patients with obstructive disease underwent surgical treatment. Five of the patients were found to have sperm in the semen three months after treatment. Five patients were found sperm in semen six months after treatment; the remaining 61 patients were given up Surgical directly requires assisted reproductive technology (ART) pregnancy, percutaneous epididymal sperm aspiration / percutaneous testicular sperm extraction - intracytoplasmic sperm injection (PESA / TESE-ICSI). Of the 129 idiopathic azoospermia patients, 113 received medication, with 74 of them having an increase in testicular volume and an elevated level of serum follicle-stimulating hormone (FSH) three months after treatment; three of 7 patients Sperm found in the semen; seven patients persist in treatment of semen found after six months. Thirty-two patients were selected for artificial insemination (AID). Conclusions: Patients with obstructive azoospermia can be treated with surgery or assisted reproductive therapy. Patients with idiopathic azoospermia should be treated with systematic medication and patients should be observed for a certain period of time. If the treatment is ineffective, AID therapy should be considered.