动脉吻合方式对肾移植受者性活动影响的探讨  

Erectile function in male kidney transplant recipients and effects of different methods of renal arterial anastomosis

作　　者：范连慧[1] 何龙[1] 吴晓倩 向军[1] 刘龙[1] 

机构地区：[1]沈阳军区总医院泌尿外科,沈阳110016 [2]解放军第四六三医院神内科,沈阳110042

出　　处：《中国性科学》2013年第11期3-5,15,共4页Chinese Journal of Human Sexuality

摘　　要：目的:探讨肾移植受者动脉吻合方式对性活动的影响。方法:对接受肾移植(首次及二次移植)的580例男性患者术后的性功能状态进行问卷调查及进行阴茎血流多普勒超声检查。500例接受首次肾移植的患者中,328例选用受者髂外动脉与移植肾动脉吻合(A组);172例选用受者髂内动脉与移植肾动脉吻合(B组)。另80例二次肾移植的受者中,两次移植选用髂外动脉与供肾动脉吻合者20例(C组);一侧选用髂内动脉另一侧选用髂外动脉吻合者33例(D组);均选用髂内动脉与供肾动脉吻合者27例(E组),其中包括同期行双肾移植的1例患者。结果:半年后大部分患者可恢复正常性生活,A组患者中236例,B组123例,C组13例,D组21例,E组5例。E组患者的阴茎海绵体动脉收缩期最大血流速度(PSV)明显低于其他各组。结论:肾移植患者(单次或二次移植),只要保留一侧髂内动脉通畅,对受者的性生活无明显影响;两次肾移植均选用髂内动脉与供肾动脉吻合,对患者的性生活有影响;但通过侧支循环代偿一段时间后,一部分患者仍可有满意的性生活。Objectives： To investigate the erectile function in patients with renal failure before and after renal transplanta tion and the effects of different methods of renal arterial anastomosis. Method： 580 kidney graft recipients responded to the ques tionnaire. The penis cavemosal artery flow of these patients were examined by Color Doppler Ultrasonography. Among the 500 ca ses receiving first time renal transplant, 328 recipients received kidney transplantation with their external iliac arteries anasto mosed to the donor renal arteries （Group A）, and 172 recipients with their internal iliac arteries anastomosed to the donor renal arteries （Group B）. Among the 80 cases receiving second renal transplant, 20 recipients received a bilateral kidney transplanta tion with their bilateral external iliac arteries anastomosed to the donor renal arteries （ Group C）, 33 recipients with their unilater al external iliac arteries and the other internal iliac arteries anastomosed to the donor renal arteries （ Group D）, and 27 recipients with their internal iliac arteries anastomosed to the donor renal arteries （Group E）. Results： 236 recipients of Group A, 123 of Group B, 13 of Group C, 21 of Group D, 5 of Group E recovered normal sexual function after 6 months of kidney transplantation. The peak systole velocity （PSV） in Group E was significantly slower than that in Group A, Group B, Group C and Group D. Conclusion： The renal transplant recipients with unblocking of unilateral internal iliac arteries will enjoy normal sex function. Sexual life will be influenced if recipients performs bilateral kidney transplantation with their bilateral internal iliac arteries anastomosed to donor renal arteries. However, some recipients might enjoy satisfactory sexual life after establishing of lateral branch cir culation.

关 键 词：肾移植 血管吻合 性功能 

分 类 号：R699.2[医药卫生—泌尿科学]