全子宫切除术对妇女性行为的影响  

The effect of hysterectomy on sexual behavior in women

作　　者：杨丹[1,2] 于传鑫[1,2] 

机构地区：[1]上海医科大学中山医院妇产科 [2]上海医科大学妇产科医院

出　　处：《中华医学杂志》1999年第6期441-442,共2页National Medical Journal of China

摘　　要：目的探讨全子宫切除术后对患者性行为的影响因素，以提高术后妇女的生活质量。方法观察了１０７例行全子宫切除手术６个月以上患者，其中全子宫切除１９例，全子宫及单侧附件切除１８例和双附件切除７０例。按不同术式及年龄＜４５岁、４５～５０岁、＞５０岁分组，对术后性生活的恢复、性生活的频率及质量等进行手术前、后自身比较，并观察促卵泡刺激素（ＦＳＨ）、雌二醇（Ｅ２）及睾酮（Ｔ）水平对性行为的影响。结果术后性生活恢复时间各组间差异无显著意义，术后４７例（４３９％）患者恢复性功能如同术前，有性行为异常（性生活频率减少、性交痛及缺乏性高潮）为２８例（２６２％），１９例（１７８％）患者有术后恐惧心理或误认为需要禁欲。不同术式同一年龄组中术后性生活恢复时间及频率方面差异无显著意义。而年龄＜４５岁３组不同术式比较在性生活质量及性欲望的差异方面有显著意义（χ２＝１１．２６３３，Ｐ＝０．００３６），不同术式组ＦＳＨ、Ｅ２水平差异有显著意义，而Ｔ水平差异无显著意义，Ｅ２水平对性生活质量及性欲望影响明显（ｔ＝２．１８，Ｐ＝０．０３２），ＦＳＨ、Ｔ则不明显。结论全子宫切除术本身对妇女的性行为影响不明显，术前术后对患者的指导，消除心理障碍显?Objectives To explore the effect of total hysterectomy on sexual behavior in women and to improve the quality of life in posthysterectomic women. Methods We observed 107 of patients who had received surgery for more than six months. They were divided into 3 groups: 1st group (19 pationts), hysterectomy; 2nd group (18), unilateral salpingo oophorectomy and hysterectomy; and 3rd group (70), bilateral salpingo oophorectomy and hysterectomy. The patients were also divided into groups(< 45 years,45～50 years, > 50 years) according to age. The difference of sexual behavior before and after hysterectomy was compared and the effect of FSH, E 2, T on sexual behavior was also analysed. Results Sexual function after hysterectomy was normal in 43.9%, sexual disturbance 26.2%, fear or misunderstanding 17.8%, and no partner or ill partner 12.2%. Sexual function and sexual desire in the <45 years group was significantly different from other groups (χ 2= 11.263 3, P =0.003 6). The effect of E 2 on sexual function and desire was significant ( t=2.18,P= 0 032). Conclusions Total hysterectomy affects sexual behavior. It is highly important to advise patients to get rid of psychosomatic disturbances before and after hysterectomy. Since overian function is very important for maintenance of normal sexual function, it is not advisable to do preventive overiotomy. The estrogen level has a great influence on the sexual behavior of women who had hysterectomy, but the role of androgen in women’s sexual behavior needs to be studied.

关 键 词：女性 子宫切除 性行为 雌激素类 雄激素类 

分 类 号：R713.42[医药卫生—妇产科学]