男性全膀胱切除及尿流改道术后影响性功能障碍的相关因素研究  

Study on sexual dysfunction in patients treated by total resection of the bladder and urinary diersion and its related factors

作　　者：林燕平[1] 邱金花[1] 林宁[1] 阮爱梅[1] 曹莲芳[1] 林峥[1] 连丹[1] 陈枫[1] 卢丽钦 

机构地区：[1]福建医科大学附属第一医院泌尿外科

出　　处：《中国男科学杂志》2015年第1期18-21,共4页Chinese Journal of Andrology

摘　　要：目的：研究全膀胱切除及尿流改道术后影响男性患者性功能障碍的相关因素。方法对2004年1月至2014年6月行膀胱全切及尿流改道术男性患者112例，采用国际勃起功能（IIEF-5）评分、国际尿控协会问卷的简短版本（ICIQ-SF）评分、焦虑自评量表（SAS）、抑郁自评量表（SDS）、自制性高潮功能障碍问卷，进行回顾性调查。并应用Logistic回归进行多因素分析。结果（1）发放120份问卷，回收112份，回收率为93.3%，其中有性生活的82例患者纳入本研究。（2）以年龄分组，勃起功能障碍（ED）发病率为28.6%-81.8%，性高潮功能障碍（OA）发病率为23.8%-72.7%。性高潮功能障碍具体发病情况，14.6%患者无性高潮，57.3%患者高潮强度降低，性生活开始至性高潮时间增加发生率为52.4%。（3）患者的ED与年龄、体质量指数、ICIQ-SF评分、焦虑、血管神经保留有关，OA与年龄、体质量指数、ICIQ-SF评分、焦虑、血管神经保留有关。（4）多因素Logistic回归分析，年龄是ED、OA共同危险因素，神经保留、术前ED是ED的危险因素，高ICIQ-SF评分（16-21分）是OA的危险因素。结论性功能障碍是全膀胱切除及尿流改道术后患者常见并发症，临床医生应注意筛查其影响因素有年龄、神经保留、术前ED、高ICIQ-SF评分。Objective To study sexual dysfunction in male patients who underwent the complete resection of the bladder and urinary diersionand explore its related factors. Methods From January 2004 to June 2014, 112 male patients who underwent bladder full cut and urinary diersion were enrolled in the study. Retrospective survey was carried out such as the international erectile function （IIEF -5） score, ICIQ - SF, grading, self-evaluation of anxiety scale （SAS）, depression self rating scale （SDS）, self orgasm dysfunction questionnaire, And multi-factor analysis was done using Logistic regression. Results （1）The recovery rate of questionnaires was 93.3%（112/120）. 82 patients of them who have sexual life were enrolled in this study. （2） age roup, for example, the incidence of erectile dysfunction was 28.6%-81.8%, orgasm dysfunction incidence of 23.8%-72.7%. （3）The sury show that age, body mass index, ICIQ -SF score, anxiety, blood vessels, nerve preservation have related to erectile dysfunction.at the same time, age, body mass index, ICIQ-SF score, anxiety, blood vessels, nerve preservation have related to sexual orgasm dysfunction. （4） the multi-factor Logistic regression analysis showed that age, nerve preservation, preoperative ED were important factors for independently prediction of erectile dysfunction age, high ICIQ-SF score （16-21 points） were important factors for independently prediction of orgasmic dysfunction. Conclusion Sexual dysfunction is a common complication of patients with radical cystectomy and urinary diversion.More attention should be paid to Sexual dysfunction in clinical practice.The impact factors of Sexual dysfunction among radical cystectomy and urinary diversion include age, nerve preservation, preoperative ED, high ICIQ-SF score.

关 键 词：膀胱切除术 尿流改道术 勃起功能障碍 

分 类 号：R699[医药卫生—泌尿科学] R698.1[医药卫生—外科学]