中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2010年
4期
252-254
,共3页
马玉坤%杨临洪%陈丽成%吴荣德
馬玉坤%楊臨洪%陳麗成%吳榮德
마옥곤%양림홍%진려성%오영덕
隐睾%生育力%随访研究
隱睪%生育力%隨訪研究
은고%생육력%수방연구
Cryptorchids%Fertility%Follow-up studies
目的 评价双侧隐睾手术患儿的生育能力,探讨影响手术远期效果的相关因素,为双侧隐睾全面有效的治疗提供依据.方法 随访1987年至2003年在我院行进行手术治疗且目前已年满18周岁的46例双侧隐睾患儿,检测其精液常规,所得结果进行统计学分析.结果 总计有18例(39.1%)具有生育能力.按手术年龄分组:<2岁组6例(50%),2～5岁组6例(60%),6～12岁组5例(26.3%),>12岁组1例(20%).根据双侧隐睾的解剖位置分组:高位组1例(25%)具有生育能力,中位组9例(30%),低位组8例(66.6%).根据术中所见睾丸的发育情况分组:轻度发育不良组12例(66.6%),中度发育不良组6例(27.2%),重度发育不良组均不具有生育能力.根据术中能否将睾丸无张力放置在阴囊内分组:无张力组15例(51.7%),张力组3例(17.6%).结论 双侧隐睾生育能力受多重冈素共同作用,手术后的生育率仍较低,也无法做到准确预测,但是规范的治疗和细致的操作的确能明显改善双侧隐睾患儿的预后.
目的 評價雙側隱睪手術患兒的生育能力,探討影響手術遠期效果的相關因素,為雙側隱睪全麵有效的治療提供依據.方法 隨訪1987年至2003年在我院行進行手術治療且目前已年滿18週歲的46例雙側隱睪患兒,檢測其精液常規,所得結果進行統計學分析.結果 總計有18例(39.1%)具有生育能力.按手術年齡分組:<2歲組6例(50%),2～5歲組6例(60%),6～12歲組5例(26.3%),>12歲組1例(20%).根據雙側隱睪的解剖位置分組:高位組1例(25%)具有生育能力,中位組9例(30%),低位組8例(66.6%).根據術中所見睪汍的髮育情況分組:輕度髮育不良組12例(66.6%),中度髮育不良組6例(27.2%),重度髮育不良組均不具有生育能力.根據術中能否將睪汍無張力放置在陰囊內分組:無張力組15例(51.7%),張力組3例(17.6%).結論 雙側隱睪生育能力受多重岡素共同作用,手術後的生育率仍較低,也無法做到準確預測,但是規範的治療和細緻的操作的確能明顯改善雙側隱睪患兒的預後.
목적 평개쌍측은고수술환인적생육능력,탐토영향수술원기효과적상관인소,위쌍측은고전면유효적치료제공의거.방법 수방1987년지2003년재아원행진행수술치료차목전이년만18주세적46례쌍측은고환인,검측기정액상규,소득결과진행통계학분석.결과 총계유18례(39.1%)구유생육능력.안수술년령분조:<2세조6례(50%),2～5세조6례(60%),6～12세조5례(26.3%),>12세조1례(20%).근거쌍측은고적해부위치분조:고위조1례(25%)구유생육능력,중위조9례(30%),저위조8례(66.6%).근거술중소견고환적발육정황분조:경도발육불량조12례(66.6%),중도발육불량조6례(27.2%),중도발육불량조균불구유생육능력.근거술중능부장고환무장력방치재음낭내분조:무장력조15례(51.7%),장력조3례(17.6%).결론 쌍측은고생육능력수다중강소공동작용,수술후적생육솔잉교저,야무법주도준학예측,단시규범적치료화세치적조작적학능명현개선쌍측은고환인적예후.
Objective To analyze the factors influencing fertility capacity of the patients underwent surgical treatment for bilateral cryptorchidism.Methods Fertility capacity was determined by semen detection test on the 46 patients with bilateral cryptorchidism at this center between 1987 and 2003.All of the patients were older than 18 years when this study was done.Results Of the 46 patients, 18 (39.1%) had fertility capacity, including 6 (6/12, 50%) underwent surgery less than 2 years, 6 (6/10, 60%) between 2 to 5 years, 5 (5/19, 26.3%) between age of 6 to 12 years, and 1(1/5, 20%) older than 12 years.According to the location of testis at operation, the 18 patients with fertility capacity were grouped into high (1/4, 25%), median (9/30, 30%) and low group (8/12,66.6%).Twelve patients (12/18, 66.6%) had mild abnormal testicular development at the time when the surgery was performed, and 6 (6/22, 27.2%) had medium abnormal testicular development.Of the 18 patients had fertility capacity, 15 (15/29, 51.7%) had free tension on the spermatic cord during surgery, and the other 3 (3/17, 17.6 %) had spermatic cord tension.Conclusions Many factors affect fertility capacity of the patients underwent surgery for bilateral cryptorchidism.The postoperative fertility rate is low and unpredictable in patients with bilateral cryptorchidism.Proper individual-based treatments can significantly improve the prognosis.
