CAJ | 학술논문

目的：探讨输精管滤过装置（IVD）植入术对远期复通效果的影响。方法4例输精管滤过装置（IVD）植入术后4~10年的患者，术中探查并切除2.5~5.5cm长输精管，行输精管端端吻合术；2例切除段输精管送病检；术后定期复查精液常规。结果1年内随访结果：（1）复通效果：仅1例（切除长度在3 cm内）术后精液恢复正常（精子浓度均＞20×106/mL），其他3例均为严重少精子症且其中1例3个月及之后精液检查为无精子症，考虑术后继发吻合口梗阻；（2）受孕率：2例有生育要求的，仅1例（精液恢复正常）术后6个月女方妊娠；（3）淤积症状改善：2例因附睾淤积症要求手术治疗，术后改善明显，阴囊胀痛基本消失。2例病理报告：输精管平滑肌组织增生。结论输精管滤过装置（IVD）具有良好的生物相容性，术后近期复通效果满意，但是，作为腔内物理装置，长期刺激管壁，引起管壁组织增生，可能导致长段输精管损伤，由于研究样本例数较少，其远期复通效果需要进一步评价。
목적：탐토수정관려과장치（IVD）식입술대원기복통효과적영향。방법4례수정관려과장치（IVD）식입술후4~10년적환자，술중탐사병절제2.5~5.5cm장수정관，행수정관단단문합술；2례절제단수정관송병검；술후정기복사정액상규。결과1년내수방결과：（1）복통효과：부1례（절제장도재3 cm내）술후정액회복정상（정자농도균＞20×106/mL），기타3례균위엄중소정자증차기중1례3개월급지후정액검사위무정자증，고필술후계발문합구경조；（2）수잉솔：2례유생육요구적，부1례（정액회복정상）술후6개월녀방임신；（3）어적증상개선：2례인부고어적증요구수술치료，술후개선명현，음낭창통기본소실。2례병리보고：수정관평활기조직증생。결론수정관려과장치（IVD）구유량호적생물상용성，술후근기복통효과만의，단시，작위강내물리장치，장기자격관벽，인기관벽조직증생，가능도치장단수정관손상，유우연구양본례수교소，기원기복통효과수요진일보평개。
Objective To investigate the effects of long-term intra vas device (IVD) implantation on reversal of vas deferens. Methods Four patients who underwent intra vas device (IVD) implantation 4~10 years ago.The ptients received surgical exploration and resection of 2.5~5.5cm long segment of vas deferens of vas deferens, end to end anastomosis; 2 cases of resection of segment of vas deferens were collected for pathological examination; Semen analysis of the patients was frequently detected during follow-up. Results 1 years follow-up results were as follows: (1) recanalization results: only 1 cases (resection length within 3 cm ) had semen parameter recovery (sperm concentration > 20×106/mL)after operation, the other 3 cases had severe oligozoospermia and 1 cases of azoospermia semen examination after 3 months, indicating secondary anastomotic block; (2)the conception rate: 2 cases had fertility requirements, only 1 cases (semen normal) whose wife had pregnancy after 6 months later; (3) the symptoms of cholestasis: 2 cases of epididymal stasis received operation treatment, and the symptom was significant improved after surgery, and scrotal distending pain disappeared. 2 cases were diagnosed as vas deferens smooth muscle hyperplasia. Conclusion Intra vas device (IVD) has good biocompatibility and postoperative early recanalization is satisfactory.However, as a physical device cavity, long-term stimulation can result in tube wall tissue hyperplasia. Due to limitation of sample size, recanalization effect needs to be further study.