3D打印输精管夹在输精管梗阻性无精子症动物模型中的应用研究

摘要

Objective:To investigate the formation of microsurgical animal model of obstructive azoospermia andevaluate the advantages and improvements of 3D printing vas deferens clip for microsurgery.Methods:According to age and weight,20 healthy male SD rats aged 6 weeks old were selected as the experiment objects to establish a model of obstructive azoospermia by bilateral vasoligation.They were divided into four groups,including sham operation group,control group,traditional anastomosis group and 3D printing vas deferens group.In addition to the sham operation group,the rest groups received nearly about 1 cm epididymis end of line bilateral vasectomy for animal model.Experimental group received traditional anastomosis method or 3D printing vas deferens anastomosis clip method after 2 weeks respectively.After 12 weeks,the rats were executed.The anastomotic stoma,vasectomy and sperm granuloma formation were detected.Methylthionine chloride was injected from vas deferens epididymis end to enterocoelia to evaluate mechanical repass rate of anastomotic stoma by blue dye appearance in urine.Results:The mechanical repass rate oftraditional anastomosis group and 3D printing vas deferens groupwere 75％ and 88.8％ respectively(P ＜ 0.05);sperm granuloma formation rate were 12.5％ and 11.1％ respectively;the average operation time were (42 ± 4.9) min and (32 ± 3.3) min (P ＜ 0.05).Conclusions:The formation of microsurgical animal model of obstructive azoospermia is feasible.3 D printing vas deferens clamp can effectively shorten the operation time and improve the repass rate,which is a good choice for microvasovasostomy.%目的:探索梗阻性无精子症动物模型的制作方法,研究3D打印输精管夹在显微镜下输精管吻合术中的优点及改进.方法:将20只6周龄雄性SD大鼠随机分成4组,包括假手术组,对照组,传统吻合组,3D打印输精管夹组.除了假手术组外,其余组大鼠都行近附睾端约1cm处行双侧输精管结扎术,制作输精管梗阻性无精子症动物模型;对照组只行输精管结扎术,假手术组我们把睾丸移出腹腔后再移回原位.实验组2周后分别行传统吻合法,3D打印输精管夹法吻合,12周后处死大鼠,检测吻合口和输精管结扎处精子肉芽肿形成情况,从输精管的附睾端向腹腔端注射美兰,通过尿液是否出现蓝染,检测吻合口的机械再通率.结果:传统吻合组,3D打印输精管夹组的机械再通率分别是75.0％,88.8％ (P ＜0.05),精子肉芽肿的形成率分别是12.5％,11.1％,平均手术时间是(42±4.9)min,(32±3.3)min(P ＜0.05).结论:近附睾端约1cm处行双侧输精管结扎术,制作输精管梗阻性无精子症动物模型的方法简单,可靠,适用于显微输精管吻合技术训练.3D打印输精管夹可以有效缩短手术时间,提高了手术再通率,对于显微输精管吻合术,是一个不错的选择.