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目的研究男性不育无精子症的病因及治疗措施。方法对2007年12月—2011年12月1083例在郑州大学第三附属医院生殖中心男科门诊诊断为无精子症的病例,按照WHO的诊断分类标准,进行回顾性分析,根据不同的分类选择合适的治疗。结果梗阻性无精子症470例;非梗阻性无精子症324例;特殊原因所致的无精子症289例。56例患者接受了手术治疗,10例行输精管-输精管吻合术,46例行输精管附睾吻合术。65例患者接受药物治疗,其中16例炎症性梗阻患者给予抗生素治疗,49例低促性腺激素性腺功能低下的患者给予激素治疗。接受体外卵胞浆内单精子显微注射技术(ICSI)治疗者384例,供精人工授精(AID)639例。结论对于无精子症的诊断、分类以及治疗应建立一个标准的流程,通过对无精子症病因的分析,可以最大限度地检出可以治愈或依靠辅助生殖技术可以生育的病例,同时避免使用不恰当的治疗方法。
Objective To study the etiology and treatment of male infertility without azoospermia. Methods From December 2007 to December 2011, 1083 cases of azoospermia diagnosed in male outpatient department of Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed according to the diagnostic criteria of WHO, and were selected according to different classification Treatment. Results Obstructive azoospermia in 470 cases; non-obstructive azoospermia in 324 cases; special causes of azoospermia in 289 cases. Fifty-six patients underwent surgery, 10 underwent vas deferens anastomosis and 46 underwent vas deferens anastomosis. Sixty-five patients received medical therapy, of whom 16 received antibiotic therapy for inflammatory obstruction and 49 received hypoglycemic treatment for hypogonadotropic hypogonadism. A total of 384 ICSI patients were treated with in vitro cytosolic sperm injection (639 AID). Conclusions A standard procedure should be established for the diagnosis, classification and treatment of azoospermia. By analyzing the etiology of azoospermia, cases can be detected to the maximum extent that can be cured or assisted by assisted reproductive technology, while avoiding inappropriate use The treatment.