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1、中国修复重建外科杂志2005年第19卷第9期·729·犬自体睾丸移植术式的改进#张炜王玲珑张杰张茨【摘要】目的建立犬自体睾丸移植术的改进方法。方法健康成年雄性杂种犬30只,年龄1.5～210岁,体重14～17kg。切取带腹主动脉瓣和下腔静脉瓣的睾丸动、静脉,并进行灌注及冷保存。将睾丸动、静脉分别与同侧髂外动、静脉进行端侧吻合,行自体睾丸移植术30只。对睾丸灌注、带瓣睾丸血管的切取及血管吻合等关键步骤进行了改进。观察术后犬生存情况,对移植的睾丸进行影像学及组织学检查,测定犬术后不同时间点的性激素水平。结果自体
2、睾丸移植30只,成功27只,成功率90%。其中睾丸热缺血415±019min,冷缺血5010±1010min,睾丸血管吻合3515±515min,总手术时间315±015h。数字减影动脉造影(digitalsubtractionarteriography,DSA)证实成活睾丸血供良好;组织学检查显示精曲小管的各期生精细胞形态无异常,层次及数量无减少,管腔内有少量精子;术后各时间点,黄体生成素较术前明显升高,差异有统计学意义(P<0105),睾酮及卵泡刺激素与术前差异均无统计学意义(P>0105)。结论建立了
3、改进后稳定而可行的犬自体睾丸移植的手术方法,为研究人睾丸移植提供了可靠的依据。【关键词】睾丸自体移植术式改进犬中图分类号:R699.8R61612文献标识码:AMODIFIEDTECHNIQUEOFTESTICULARAUTOTRANSPLANTATIONINDOGSöZHANGWei,WANGLinglong,ZHANGJie,etal.DepartmentofUrology,People'sHospitalofWuhanUniversity,WuhanHubei,430060,P.R.ChinaCorr
4、espondingauthor:ZHANGJie,E2mail:zhangjie888@sina.com【Abstract】ObjectiveToestablishdogmodeloftesticularautotransplantationwithamodifiedtechnique.MethodsTesticularautotransplantationswereperformedontherightsideof30maledogs,whoseagesrangedfrom115to2.0yearsold
5、andweightsrangedfrom14to17kg.Afterthespermaticarterywithacuffofabdominalaortaandspermaticveinandwithacuffofinferiorvenacavaweredetached,thetestiswasperfusedandkeptaticingtemperature.Anend2to2sideanastomosisofthespermaticvesselstotheexternaliliacvesselswasc
6、onductedsubsequently.Thesurvivalconditionsoftheautograftswereassessedbydigitalsubtractionarteriography(DSA).Histologicalexaminationanddetectionontheserumlevelsoffolliclestimulatinghormone(FSH),luteotrophichormone(LH),andtestosterone(T)weremadeattwoweeksint
7、ervals.ResultsOfthe30testicularautotransplantationsperformed,27casesweresuccessful.Thesuccessratewas90%.Thetimeofheatischemia,coldischemia,anastomosisofspermaticvessels,andtotaloperationwas4.5±0.9minutes,50.0±10.0minutes,3515±515minutes,and315±015hoursresp
8、ectively.DSAprovedthatthetestissurvivedwell.Nomorphologicalabnormalitywasfoundatdifferentstagesofthespermatogeniccells.TheLHlevelwashigherthanthatbeforeoperation,beingstatisticallydifferent(P<0105);however,th
