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目的:比较三种不同穿刺针用于睾丸穿刺取精术(TESA)的效果和并发症,以助于临床选择。方法:先后使用1.6侧孔针、0.7蝶形针和1.2侧孔针对188例无精子症患者实施TESA,分别为102例、41例和45例。比较各自穿刺针数及1周内阴囊血肿、感染的发生率。结果:三种穿刺针术后1周内均未见明显并发症。采用1.6侧孔针进行1~3次穿刺,99例获得足够睾丸组织。0.7蝶形针获得满意组织,梗阻性无精子症(OA)患者需要(3.62±0.80)次穿刺,非梗阻性无精子症(NOA)患者需要(5.50±1.10)次。1.2侧孔针用于OA和NOA患者分别需要穿刺(1.95±0.69)次和(2.92±1.15)次。0.7蝶形针穿刺次数多于1.2侧孔针(P<0.05)。NOA患者比OA更难穿刺获得睾丸组织(P<0.05)。结论:OA和NOA患者以0.7蝶形针行TESA术,均需要比1.6和1.2侧孔针更多的穿刺针数,可能增加潜在并发症。拟行TESA的NOA患者,建议采用1.2侧孔针。
Objectives: To compare the efficacy and complications of three different puncture needles for testicular aspiration (TESA) to aid clinical choice. Methods: TESA was performed in 188 patients with azoospermia using a 1.6-sided, a 0.7-styled and a 1.2-sided holes, 102, 41 and 45, respectively. Compare the number of puncture needle and scrotum hematoma in 1 week, the incidence of infection. Results: Three kinds of puncture needle showed no obvious complications within 1 week after operation. 1.6 side hole needle for 1 to 3 puncture, 99 cases of adequate testicular tissue. With a 0.7-gauge needle, satisfactory (3.62 ± 0.80) punctures were required for obstructive azoospermia (OA) and 5.50 ± 1.10 for non-obstructive azoospermia (NOA). 1.2 side hole needle for patients with OA and NOA need to puncture (1.95 ± 0.69) times and (2.92 ± 1.15) times. The number of stitches at 0.7 was more than that of stitches at 1.2 (P <0.05). Patients with NOA were more likely to have testicular tissue than those with OA (P <0.05). Conclusions: Patients with OA and NOA who underwent TESA with a 0.7 butterfly needle required more needles than those with 1.6 and 1.2 side holes, potentially increasing the potential for complications. Proposed TESA NOA patients, it is recommended to use 1.2 side hole needle.