{"id":339,"date":"2016-10-17T23:08:55","date_gmt":"2016-10-17T16:08:55","guid":{"rendered":"https:\/\/benhvienvietbi.vn\/en\/?p=339"},"modified":"2021-01-06T09:04:59","modified_gmt":"2021-01-06T02:04:59","slug":"vo-sinh-nam-vi-khong-con-giong","status":"publish","type":"post","link":"https:\/\/benhvienvietbi.vn\/en\/vo-sinh-nam-vi-khong-con-giong\/","title":{"rendered":"[:vi]V\u00f4 sinh nam v\u00ec kh\u00f4ng ”con gi\u1ed1ng”[:]"},"content":{"rendered":"

[:vi]<\/p>\n

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Ngu\u00f4\u0300n: Ba\u0301o 24h<\/p>\n

Theo ti\u1ebfn s\u0129 L\u00ea V\u01b0\u01a1ng V\u0103n V\u1ec7, kh\u00f4ng tinh tr\u00f9ng l\u00e0 trong tinh d\u1ecbch kh\u00f4ng c\u00f3 \u201ccon gi\u1ed1ng\u201d, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y v\u00f4 sinh \u1edf nam gi\u1edbi.<\/p>\n<\/div>\n

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BS L\u00ea V\u01b0\u01a1ng V\u0103n V\u1ec7 – Hi\u1ec7n l\u00e0 Gi\u00e1m \u0111\u1ed1c B\u1ec7nh vi\u1ec7n Chuy\u00ean khoa Nam h\u1ecdc v\u00e0 Hi\u1ebfm mu\u1ed9n Vi\u1ec7t – B\u1ec9 c\u00f9ng nh\u00f3m c\u1ed9ng s\u1ef1 v\u1eeba c\u00f4ng b\u1ed1 k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u 415 tr\u01b0\u1eddng h\u1ee3p v\u00f4 sinh nam kh\u00f4ng c\u00f3 tinh tr\u00f9ng trong tinh d\u1ecbch (Azoospermia) \u1edf 2.150 c\u1eb7p hi\u1ebfm mu\u1ed9n \u0111\u01b0\u1ee3c kh\u00e1m v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ea1i b\u1ec7nh vi\u1ec7n n\u00e0y trong nh\u1eefng n\u0103m qua.<\/p>\n

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Kh\u00f4ng \u201ccon gi\u1ed1ng\u201d – nguy\u00ean nh\u00e2n g\u00e2y v\u00f4 sinh \u1edf nam gi\u1edbi<\/strong><\/p>\n

Theo ti\u1ebfn s\u0129 L\u00ea V\u01b0\u01a1ng V\u0103n V\u1ec7, kh\u00f4ng tinh tr\u00f9ng l\u00e0 trong tinh d\u1ecbch kh\u00f4ng c\u00f3 \u201ccon gi\u1ed1ng\u201d, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y v\u00f4 sinh \u1edf nam gi\u1edbi. V\u00f4 sinh nam chi\u1ebfm t\u1ef7 l\u1ec7 45-50% trong v\u00f4 sinh, v\u00e0 kh\u00f4ng \u201ccon gi\u1ed1ng\u201d l\u1ea1i l\u00e0 nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu. B\u1ec7nh d\u1ec5 ch\u1ea9n \u0111o\u00e1n, nh\u01b0ng \u0111i\u1ec1u tr\u1ecb l\u1ea1i r\u1ea5t kh\u00f3 kh\u0103n. Tuy v\u1eady, v\u1edbi ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb, \u0111\u1eb7c bi\u1ec7t l\u00e0 h\u1ed7 tr\u1ee3 sinh s\u1ea3n c\u00f3 kho\u1ea3ng 75-80% nam gi\u1edbi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n kh\u00f4ng tinh tr\u00f9ng trong tinh d\u1ecbch v\u1eabn c\u00f3 con b\u1eb1ng tinh tr\u00f9ng c\u1ee7a m\u00ecnh.<\/p>\n

Tri\u1ec7u ch\u1ee9ng c\u1ee7a kh\u00f4ng tinh tr\u00f9ng, theo ti\u1ebfn s\u0129 V\u1ec7, r\u1ea5t kh\u00f3 ch\u1ea9n \u0111o\u00e1n, n\u1ebfu kh\u00f4ng x\u00e9t nghi\u1ec7m, ph\u00e2n t\u00edch tinh d\u1ecbch. \u201cTr\u00ean l\u00e2m s\u00e0ng ch\u00fang t\u00f4i g\u1eb7p nhi\u1ec1u nam gi\u1edbi h\u00ecnh th\u1ee9c \u01b0a nh\u00ecn, t\u00ecnh d\u1ee5c v\u1eabn t\u1ed1t, tr\u00ed tu\u1ec7 ph\u00e1t tri\u1ec3n nh\u01b0ng tinh d\u1ecbch l\u1ea1i kh\u00f4ng c\u00f3 tinh tr\u00f9ng. V\u00e0 ch\u1ec9 c\u00f3 ph\u00e2n t\u00edch tinh d\u1ecbch m\u1edbi x\u00e1c \u0111\u1ecbnh l\u00e0 Azoo hay kh\u00f4ng?\u201d – ti\u1ebfn s\u0129 V\u1ec7 n\u00f3i. Nguy\u00ean nh\u00e2n kh\u00f4ng tinh tr\u00f9ng v\u00f4 c\u00f9ng ph\u1ee9c t\u1ea1p, trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng ng\u01b0\u1eddi ta chia l\u00e0m hai lo\u1ea1i: Kh\u00f4ng tinh tr\u00f9ng do b\u00edt t\u1eafc \u0111\u01b0\u1eddng d\u1eabn tinh (M\u00e0o tinh ho\u1eb7c \u1ed1ng d\u1eabn tinh) v\u00e0 Kh\u00f4ng tinh tr\u00f9ng do v\u1ea5n \u0111\u1ec1 c\u1ee7a sinh tinh.<\/p>\n<\/div>\n

Nguy\u00ean nh\u00e2n s\u1ea3n xu\u1ea5t tinh tr\u00f9ng: \u0110\u00f4i khi, azoo l\u1ea1i l\u00e0 nguy\u00ean nh\u00e2n t\u1ea1i tinh ho\u00e0n kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng s\u1ea3n xu\u1ea5t tinh tr\u00f9ng, ho\u1eb7c l\u00e0 r\u1ed1i lo\u1ea1n ho\u1ea1t \u0111\u1ed9ng c\u1ee7a Tr\u1ee5c \u0111\u1ed3i th\u1ecb- tuy\u1ebfn y\u00ean – tinh ho\u00e0n. Nguy\u00ean nh\u00e2n kh\u00e1c, l\u00e0 r\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft t\u1ed1 sinh d\u1ee5c, do thi\u1ebfu n\u1ed9i ti\u1ebft ho\u1eb7c r\u1ed1i lo\u1ea1n s\u1ea3n xu\u1ea5t, m\u1ea5t c\u00e2n b\u1eb1ng c\u1ee7a qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t hay chuy\u1ec3n h\u00f3a hormone sinh d\u1ee5c. C\u1ea1nh \u0111\u00f3 l\u00e0 do tinh ho\u00e0n \u1ea9n, \u0111\u1eb7c bi\u1ec7t n\u1eb1m trong \u1ed1 b\u1ee5ng, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt tr\u01b0\u1edbc 24 th\u00e1ng, ho\u1eb7c ph\u1eabu thu\u1eadt kh\u00f4ng t\u1ed1t l\u00e0m th\u01b0\u01a1ng t\u1ed5n \u0111\u1ed9ng m\u1ea1ch, \u1ed1ng d\u1eabn tinh g\u00e2y teo tinh ho\u00e0n ho\u1eb7c t\u1eafc \u1ed1ng d\u1eabn tinh. Th\u01b0\u01a1ng t\u1ed5n h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u do ch\u1ea5n th\u01b0\u01a1ng, trong \u0111\u00f3 gi\u00e3n t\u0129nh m\u1ea1ch tinh c\u0169ng l\u00e0 nguy\u00ean nh\u00e2n l\u00e0m th\u01b0\u01a1ng t\u1ed5n qu\u00e1 tr\u00ecnh sinh tinh th\u1eadm ch\u00ed kh\u00f4ng tinh tr\u00f9ng.<\/p>\n

Azoo c\u00f2n l\u00e0 di ch\u1ee9ng c\u1ee7a quai b\u1ecb; b\u1ec7nh do gene: r\u1ed1i lo\u1ea1n nhi\u1ec5m s\u1eafc th\u1ec3; h\u1ed9i ch\u1ee9ng Klinefelter’s Syndrome (XXY), XO, XX… Do \u0111\u01b0\u1eddng d\u1eabn, nh\u01b0 th\u1eaft \u1ed1ng d\u1eabn tinh tri\u1ec7t s\u1ea3n, vi\u00eam t\u1eafc \u1ed1ng d\u1eabn tinh- m\u00e0o tinh. Do di ch\u1ee9ng c\u1ee7a b\u1ec7nh l\u00e2y qua \u0111\u01b0\u1eddng sinh d\u1ee5c (Sexually Transmitted Diseases) nh\u01b0 l\u1eadu, chlamiadia…, lao m\u00e0o tinh. Ngo\u00e0i ra do kh\u00f4ng \u1ed1ng d\u1eabn tinh b\u1ea9m sinh CBAV (Congenital Absence of Vans Deferens).<\/p>\n

Th\u1ef1c t\u1ebf l\u00e2m s\u00e0ng – nh\u1eefng con s\u1ed1 bi\u1ebft n\u00f3i<\/strong><\/p>\n

Nghi\u00ean c\u1ee9u 415 nam gi\u1edbi kh\u00f4ng tinh tr\u00f9ng trong tinh d\u1ecbch trong 2.150 c\u1eb7p v\u00f4 sinh \u0111\u01b0\u1ee3c kh\u00e1m v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ea1i B\u1ec7nh vi\u1ec7n chuy\u00ean khoa Nam h\u1ecdc v\u00e0 Hi\u1ebfm mu\u1ed9n H\u00e0 N\u1ed9i trong th\u1eddi gian t\u1eeb th\u00e1ng 1\/2006 \u0111\u1ebfn 1\/2010 cho th\u1ea5y, b\u1ec7nh kh\u00f4ng ch\u1eeba ai, c\u00f3 ng\u01b0\u1eddi l\u00e0 k\u1ef9 s\u01b0, c\u00f3 ng\u01b0\u1eddi l\u00e0 phi c\u00f4ng… B\u00e1c s\u0129, nh\u00e2n vi\u00ean y t\u1ebf g\u1eb7p b\u1ec7nh n\u00e0y kh\u00f4ng ph\u1ea3i l\u00e0 \u00edt. TS – BS L\u00ea V\u01b0\u01a1ng V\u0103n V\u1ec7 v\u00e0 c\u00e1c c\u1ed9ng s\u1ef1 \u0111\u00e3 nghi\u00ean c\u1ee9u theo ph\u01b0\u01a1ng ph\u00e1p ph\u00e2n lo\u1ea1i theo nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 gi\u1ea3i ph\u1eabu (do \u0111\u01b0\u1eddng d\u1eabn hay kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn tinh); c\u00f9ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p ch\u1ea9n \u0111o\u00e1n (PESA; TESA; Biopsy; ch\u1ee5p \u1ed1ng d\u1eabn tinh\u2026), c\u0169ng nh\u01b0 ph\u00e2n t\u00edch bi\u1ebfn \u0111\u1ed5i n\u1ed9i ti\u1ebft t\u1ed1 sinh d\u1ee5c b\u1eb1ng k\u1ef9 thu\u1eadt ELISA, m\u00f4 h\u1ecdc tinh ho\u00e0n.<\/p>\n

Ti\u1ebfn s\u0129 V\u1ec7 cho r\u1eb1ng, trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh c\u00f3 nhi\u1ec1u ti\u1ebfn b\u1ed9. Th\u00e0nh c\u00f4ng c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p th\u1ee5 tinh \u1ed1ng nghi\u1ec7m, v\u00e0 ICSI m\u1edf ra t\u01b0\u01a1ng lai m\u1edbi trong \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh, \u0111\u1eb7c bi\u1ec7t l\u00e0 kh\u00f4ng tinh tr\u00f9ng trong tinh d\u1ecbch. C\u0169ng nh\u1edd \u0111\u00f3 m\u00e0 ph\u00e2n lo\u1ea1i azoospermia tr\u00ean l\u00e2m s\u00e0ng c\u0169ng \u0111\u01a1n gi\u1ea3n v\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n. \u201c\u1ede n\u01b0\u1edbc ta, \u0111\u00e3 c\u00f3 nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng tinh tr\u00f9ng l\u1ea5y t\u1eeb tinh ho\u00e0n, hay m\u00e0o tinh b\u1eb1ng c\u00e1c th\u1ee7 thu\u1eadt MESA.PESA, TESE.TESE, ho\u1eb7c PESE \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00f4 sinh do azoo kh\u00f4ng tinh tr\u00f9ng \u0111\u1ec3 h\u1ed7 tr\u1ee3 sinh s\u1ea3n. Ch\u00fang t\u00f4i ti\u1ebfn h\u00e0nh nghi\u00ean c\u1ee9u 415 v\u00f4 sinh nam do kh\u00f4ng tinh tr\u00f9ng trong tinh d\u1ecbch, nh\u1eb1m m\u1ee5c ti\u00eau ph\u00e2n t\u00edch nh\u1eefng bi\u1ebfn \u0111\u1ed5i v\u1ec1 n\u1ed9i ti\u1ebft sinh d\u1ee5c, m\u00f4 h\u1ecdc tinh ho\u00e0n \u1edf nh\u00f3m do \u0111\u01b0\u1eddng d\u1eabn v\u00e0 kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn v\u00e0 ph\u00e2n lo\u1ea1i azoo do \u0111\u01b0\u1eddng d\u1eabn v\u00e0 kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn, c\u0169ng nh\u01b0 nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh\u201d – ti\u1ebfn s\u0129 V\u1ec7 n\u00f3i.<\/p>\n

X\u00e9t nghi\u1ec7m tinh d\u1ecbch \u0111\u1ed3, trong 2150 c\u1eb7p c\u00f3 415 kh\u00f4ng tinh tr\u00f9ng trong tinh d\u1ecbch, azoo chi\u1ebfm kho\u1ea3ng 10 – 20% trong ph\u00e2n t\u00edch m\u1eabu tinh d\u1ecbch. Sau khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh l\u00e0 v\u00f4 sinh do kh\u00f4ng tinh tr\u00f9ng trong tinh d\u1ecbch, c\u00e1c b\u00e1c s\u1ef9 ti\u1ebfn h\u00e0nh c\u00e1c x\u00e9t nghi\u1ec7m v\u00e0 th\u1ee7 thu\u1eadt can thi\u1ec7p. Khi nghi\u00ean c\u1ee9u Azoo, c\u00e1c b\u00e1c s\u1ef9 c\u0169ng \u0111\u01b0a ra qui tr\u00ecnh kh\u00e1m, x\u00e9t nghi\u1ec7m c\u00f3 gi\u00e1 tr\u1ecb trong t\u00ecm nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh. V\u1ec1 n\u1ed9i ti\u1ebft sinh d\u1ee5c, nghi\u00ean c\u1ee9u th\u1ea5y c\u00f3 t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp \u0111\u1ebfn sinh tinh qua chu tr\u00ecnh: \u0110\u1ed3i th\u1ecb – tuy\u1ebfn y\u00ean v\u00e0 tinh ho\u00e0n. B\u1edfi s\u1ef1 gi\u1ea3i ph\u00f3ng FSH, LH\u2026 t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn recepter c\u1ee7a t\u1ebf b\u00e0o leydigs v\u00e0 Sertoly theo t\u00e1c \u0111\u1ed9ng Fiedback. C\u1ee5 th\u1ec3, FSH, LH v\u00e0 Testosteron b\u00ecnh th\u01b0\u1eddng \u1edf nh\u00f3m azoo do \u0111\u01b0\u1eddng d\u1eabn th\u1ec3 hi\u1ec7n kh\u1ea3 n\u0103ng sinh tinh, c\u0169ng nh\u01b0 t\u00ecnh d\u1ee5c \u00edt bi\u1ebfn \u0111\u1ed5i. Nh\u01b0ng nh\u00f3m azoo kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn FSH; LH t\u0103ng cao v\u00e0 Testosteron gi\u1ea3m c\u00f3 \u00fd ngh\u0129a (v\u1edbi p<0,001). K\u1ebft qu\u1ea3 l\u00e0 do th\u01b0\u01a1ng t\u1ed5n kh\u00f4ng h\u1ed3i ph\u1ee5c c\u1ee7a nhu m\u00f4 tinh ho\u00e0n. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y, v\u1eeba l\u00e0 h\u1eadu qu\u1ea3, l\u1ea1i l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng sinh tinh c\u0169ng nh\u01b0 ho\u1ea1t \u0111\u1ed9ng t\u00ecnh d\u1ee5c.<\/p>\n

\u0110\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n v\u00e0 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb, theo ti\u1ebfn s\u0129 V\u1ec7, \u00f4ng v\u00e0 nh\u00f3m c\u1ed9ng s\u1ef1 ti\u1ebfn h\u00e0nh can thi\u1ec7p c\u00e1c th\u1ee7 thu\u1eadt th\u00e1m s\u00e1t m\u00e0o tinh, tinh ho\u00e0n, ch\u1ee5p ODT, ph\u00e2n t\u00edch NST. Th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt MESA, TESA, PESA\u2026 \u201cCh\u00fang t\u00f4i th\u1ea5y, h\u1ea7u nh\u01b0 b\u1ec7nh nh\u00e2n kh\u00f4ng tinh tr\u00f9ng \u0111\u01b0\u1ee3c can thi\u1ec7p th\u1ee7 thu\u1eadt \u1edf m\u00e0o tinh v\u00e0 tinh ho\u00e0n chi\u1ebfm t\u1edbi 84,57% (351\/415 tr\u01b0\u1eddng h\u1ee3p). Th\u1ee7 thu\u1eadt n\u00e0y r\u1ea5t h\u1eefu \u00edch trong ch\u1ea9n \u0111o\u00e1n, x\u1ebfp lo\u1ea1i v\u00e0 ti\u00ean l\u01b0\u1ee3ng \u0111i\u1ec1u tr\u1ecb\u201d. Ti\u1ebfn s\u0129 cho bi\u1ebft, m\u00f4 h\u1ecdc tinh ho\u00e0n k\u1ebft h\u1ee3p, ho\u1eb7c kh\u00f4ng ph\u1eabu thu\u1eadt b\u1ed9c l\u1ed9 \u1ed1ng d\u1eabn tinh l\u00e0 chu\u1ea9n v\u00e0ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh khi\u1ebfm khuy\u1ebft sinh tinh do t\u1eafc l\u00e0 nguy\u00ean nh\u00e2n azoo. Trong m\u1eabu sinh thi\u1ebft, m\u00f4 h\u1ecdc tinh ho\u00e0n h\u1ea7u nh\u01b0 b\u00ecnh th\u01b0\u1eddng \u1edf nh\u00f3m kh\u00f4ng \u1ed1ng d\u1eabn tinh v\u00e0 t\u1eafc \u1ed1ng d\u1eabn tinh – m\u00e0o tinh. C\u00f2n nh\u00f3m azoo kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn, nhu m\u00f4 tinh ho\u00e0n th\u01b0\u01a1ng t\u1ed5n, l\u00f2ng \u1ed1ng sinh tinh gi\u00e3n r\u1ed9ng l\u1ea5p \u0111\u1ea7y kho\u1ea3ng m\u1ee1 ho\u1eb7c keo h\u00f3a, t\u1ebf b\u00e0o d\u00f2ng tinh ng\u1eebng tr\u01b0\u1edfng th\u00e0nh, ch\u1ec9 c\u00f3 t\u1ebf b\u00e0o sertoly v\u00e0 x\u01a1 h\u00f3a \u1ed1ng.<\/p>\n

Trong c\u00e1c m\u1eabu ph\u00e2n t\u00edch nhi\u1ec5m s\u1eafc th\u1ec3 gi\u1edbi t\u00ednh, b\u1ea5t th\u01b0\u1eddng nhi\u1ec5m s\u1eafc th\u1ec3 chi\u1ebfm 12,79% (22\/172 tr\u01b0\u1eddng h\u1ee3p). C\u0169ng g\u1eb7p nguy\u00ean nh\u00e2n azoo do h\u1ed9i ch\u1ee9ng Klinerfelter, ho\u1eb7c chuy\u1ec3n \u0111o\u1ea1n, m\u1ea5t vi \u0111o\u1ea1n c\u1ee7a nhi\u1ec5m s\u1eafc th\u1ec3 gi\u1edbi t\u00ednh. Nghi\u00ean c\u1ee9u c\u00f2n cho th\u1ea5y, teo tinh ho\u00e0n – r\u1ed1i lo\u1ea1n sinh tinh g\u1eb7p nhi\u1ec1u nh\u1ea5t, sau \u0111\u00f3 l\u00e0 kh\u00f4ng \u1ed1ng d\u1eabn tinh b\u1ea9m sinh (70 tr\u01b0\u1eddng h\u1ee3p), t\u1eafc \u1ed1ng d\u1eabn tinh – m\u00e0o tinh g\u1eb7p 85 tr\u01b0\u1eddng h\u1ee3p.<\/p>\n

C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c, nh\u01b0 r\u1ed1i lo\u1ea1n nhi\u1ec5m s\u1eafc th\u1ec3, ti\u1ec1n s\u1eed m\u1eafc b\u1ec7nh quai b\u1ecb chi\u1ebfm 6,98%, gi\u00e3n t\u0129nh m\u1ea1ch tinh c\u00f3 15 tr\u01b0\u1eddng h\u1ee3p, tinh ho\u00e0n l\u1ea1c ch\u1ed7 c\u00f3 14 tr\u01b0\u1eddng h\u1ee3p v\u00e0 kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n l\u00e0 14 tr\u01b0\u1eddng h\u1ee3p. \u201cCh\u00fang t\u00f4i chia b\u1ec7nh nh\u00e2n th\u00e0nh hai lo\u1ea1i: azoo do \u0111\u01b0\u1eddng d\u1eabn (kh\u00f4ng \u1ed1ng d\u1eabn tinh b\u1ea9m sinh; T\u1eafc \u1ed1ng d\u1eabn tinh – m\u00e0o tinh). Nh\u00f3m kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn, c\u00f3 \u1ed1ng d\u1eabn, m\u00e0o tinh b\u00ecnh th\u01b0\u1eddng. Trong \u0111\u00f3 kh\u00f4ng \u1ed1ng d\u1eabn tinh b\u1ea9m sinh chi\u1ebfm 16,86% (70\/415 tr\u01b0\u1eddng h\u1ee3p); t\u1eafc \u1ed1ng d\u1eabn tinh – m\u00e0o tinh chi\u1ebfm 20,48% (85\/415 tr\u01b0\u1eddng h\u1ee3p), nguy\u00ean do h\u1eadu qu\u1ea3 c\u1ee7a b\u1ec7nh l\u00e2y qua \u0111\u01b0\u1eddng t\u00ecnh d\u1ee5c, lao m\u00e0o tinh, ch\u1ea5n th\u01b0\u01a1ng. Nh\u00f3m do \u0111\u01b0\u1eddng d\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt (V-E), ho\u1eb7c h\u1ed7 tr\u1ee3 sinh s\u1ea3n (ART: ICSI), v\u1edbi kh\u1ea3 n\u0103ng tr\u1edf th\u00e0nh cha sinh h\u1ecdc r\u1ea5t cao\u201d – l\u1eddi ti\u1ebfn s\u0129 V\u1ec7.<\/p>\n

T\u00f3m l\u1ea1i, k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u 415 tr\u01b0\u1eddng h\u1ee3p v\u00f4 sinh nam do azoo trong 2150 c\u1eb7p hi\u1ebfm mu\u1ed9n (chi\u1ebfm t\u1ef7 l\u1ec7 19,30%) cho th\u1ea5y, Azoo do \u0111\u01b0\u1eddng d\u1eabn chi\u1ebfm 37, 49% (155\/415 tr\u01b0\u1eddng h\u1ee3p v\u00f4 sinh nam kh\u00f4ng c\u00f3 tinh tr\u00f9ng trong tinh d\u1ecbch), v\u00e0 kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn 62,65% (260\/415 tr\u01b0\u1eddng h\u1ee3p). C\u00e1c th\u1ee7 thu\u1eadt PESA – TESA – Biopsy chi\u1ebfm 84.57% (351\/415 tr\u01b0\u1eddng h\u1ee3p); c\u00f3 tinh tr\u00f9ng trong m\u00e0o tinh v\u00e0 nhu m\u00f4 tinh ho\u00e0n chi\u1ebfm 40.17% (141\/351 tr\u01b0\u1eddng h\u1ee3p); Kh\u00f4ng tinh tr\u00f9ng, nhu m\u00f4 tinh ho\u00e0n teo, x\u01a1 h\u00f3a chi\u1ebfm 59.82% (210\/ 351 tr\u01b0\u1eddng h\u1ee3p)… N\u1ed9i ti\u1ebft sinh d\u1ee5c (FSH, LH, Testosteron) thay \u0111\u1ed5i c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m azoo kh\u00f4ng do \u0111\u01b0\u1eddng d\u1eabn. Nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh bao g\u1ed3m kh\u00f4ng \u1ed1ng d\u1eabn tinh b\u1ea9m sinh, t\u1eafc \u1ed1ng d\u1eabn tinh – m\u00e0o tinh do di ch\u1ee9ng m\u1eafc b\u1ec7nh \u0111\u01b0\u1eddng sinh d\u1ee5c, b\u1ea5t th\u01b0\u1eddng nhi\u1ec5m s\u1eafc th\u1ec3 gi\u1edbi t\u00ednh, \u0111\u1ee9t \u0111o\u1ea1n, chuy\u1ec3n vi \u0111o\u1ea1n… di ch\u1ee9ng quai b\u1ecb, gi\u00e3n t\u0129nh m\u1ea1ch tinh\u2026 v\u00e0 kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n ch\u1ec9 chi\u1ebfm 3,37% (14\/415 tr\u01b0\u1eddng h\u1ee3p).[:]<\/p>\n","protected":false},"excerpt":{"rendered":"

[:vi]Theo ti\u1ebfn s\u0129 L\u00ea V\u01b0\u01a1ng V\u0103n V\u1ec7, kh\u00f4ng tinh tr\u00f9ng l\u00e0 trong tinh d\u1ecbch kh\u00f4ng c\u00f3 \u201ccon gi\u1ed1ng\u201d, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y v\u00f4 sinh \u1edf nam gi\u1edbi. V\u00f4 sinh nam chi\u1ebfm t\u1ef7 l\u1ec7 45-50% trong v\u00f4 sinh, v\u00e0 kh\u00f4ng \u201ccon gi\u1ed1ng\u201d l\u1ea1i l\u00e0 nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu. B\u1ec7nh d\u1ec5 ch\u1ea9n \u0111o\u00e1n, nh\u01b0ng \u0111i\u1ec1u tr\u1ecb l\u1ea1i r\u1ea5t kh\u00f3 kh\u0103n. Tuy v\u1eady, v\u1edbi ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb, \u0111\u1eb7c bi\u1ec7t l\u00e0 h\u1ed7 tr\u1ee3 sinh s\u1ea3n c\u00f3 kho\u1ea3ng 75-80% nam gi\u1edbi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n kh\u00f4ng tinh tr\u00f9ng trong tinh d\u1ecbch v\u1eabn c\u00f3 con b\u1eb1ng tinh tr\u00f9ng c\u1ee7a m\u00ecnh.[:]<\/p>\n","protected":false},"author":3,"featured_media":766,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[19,38,14,22,41],"tags":[],"class_list":["post-339","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bao-chi-noi-ve-ong","category-nam-khoa","category-ts-bs-le-vuong-van-ve","category-vo-sinh-hiem-muon","category-vo-sinh-do-khong-tinh-trung"],"acf":[],"yoast_head":"\n[:vi]V\u00f4 sinh nam v\u00ec kh\u00f4ng ''con gi\u1ed1ng''[:] - VIET \u2013 BI SPECIALIZED HOSPITAL IN ANDROLOGY AND INFERTILITY<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/benhvienvietbi.vn\/en\/vo-sinh-nam-vi-khong-con-giong\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"[:vi]V\u00f4 sinh nam v\u00ec kh\u00f4ng ''con gi\u1ed1ng''[:] - VIET \u2013 BI SPECIALIZED HOSPITAL IN ANDROLOGY AND INFERTILITY\" \/>\n<meta property=\"og:description\" content=\"[:vi]Theo ti\u1ebfn s\u0129 L\u00ea V\u01b0\u01a1ng V\u0103n V\u1ec7, kh\u00f4ng tinh tr\u00f9ng l\u00e0 trong tinh d\u1ecbch kh\u00f4ng c\u00f3 \u201ccon gi\u1ed1ng\u201d, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y v\u00f4 sinh \u1edf nam gi\u1edbi. 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