男性鼻咽癌患者放疗后性功能状况及影响因素分析  

An investigation of sexual function of male nasopharyngeal cancer patients after radiotherapy and its influencing factors

作　　者：刘顺芳[1] 吕家华[1,2] 庄亮[1] 邱红[1] 胡国清[1] 孙黎[1] 

机构地区：[1]华中科技大学附属同济医院肿瘤中心,湖北武汉430030 [2]四川省肿瘤医院放疗科

出　　处：《中国男科学杂志》2016年第7期23-27,共5页Chinese Journal of Andrology

摘　　要：目的调查男性鼻咽癌患者放疗后性功能状况并分析影响因素。方法收集2008年3月起在华中科技大学附属同济医院确诊并接受放疗的男性鼻咽癌病例,用O'Leary(1995)男性性功能量表对其放疗前后性功能状况进行调查,并检测了部分患者的卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平。结果 52例男性鼻咽癌患者放疗后新发性功能障碍率34.69%(17/49),性功能过程中的性欲、勃起、射精、知觉及总满意度均有显著下降(P<0.05)。性功能障碍发生与患者对于疾病治疗预后的信心、放疗后身体恢复状况密切相关(P<0.05),与患者对疾病和性生活的错误认知、消极态度及治疗副反应严重程度密切相关(P<0.05),而与年龄、职业、文化程度、收入、既往病史、烟酒等不良嗜好、临床分期、治疗方式、性功能关注度无关。收集21例鼻咽癌患者放疗后不同时间点的血清检测激素水平,结果发现血清FSH、LH浓度均大于正常值下限,1例血清T浓度小于<1.75ng/mL外,其余均大于正常值下限。结论男性鼻咽癌患者放疗后性功能障碍发生率较放疗前明显增高,放疗及相关副反应是影响性功能的主要因素。对于疾病诊治的信心、对于疾病与性生活的认知态度以及放疗后身体恢复情况,也是影响性功能的重要因素,而年龄、文化程度、收入、职业、疾病分期、是否行诱导及同步化疗、性功能关注度与性功能障碍发生率无关。Objective To evaluate sexual function of male nasopharyngeal cancer patients after radiotherapy and explore its potential influencing factors.Methods Total of 52 male nasopharyngeal cancer patients were enrolled in the study from Tongji Hospital, Huazhong University of Science and Technology since March 2008. All patients were requested to fill out the O’Leary （1995） Brief Male Sexual function Inventory Scale and a general questionnaire containing personal and sexual function questions. Levels of follicle-stimulating hormone （FSH）, luteinizing hormone（FSH） and testosterone （T） in serum of some patients were measured. Pearsonx2, t-test were performed to do the general statistics analysis.Results Incidence of sexual dysfunction of the patients accounted for 34.69% （17/ 49）. The scores of sexual function such as desire, erection, ejaculation, consciousness, overall satisfaction were all decreased in the most of nasopharyngeal cancer patients. Confidence and generally recovery state showed a significant correlation with sexual function（P〈0.05）, whereas, incorrect understanding, complication of radiotherapy showed a negative correlation with sexual function（P〈0.05）. Age, occupation, clinical stage, income, medical history, chemotherapy and personal attention on sexual function had no correlation with sexual function. Serum levels of FSH and LH were higher than the lower limit of normal, 1 case of serum T concentration less than 〈1.75ng /ML, the rest were higher than the lower limit of normal..ConclusionThe male nasopharyngeal cancer patients who received radiotherapy experienced sexual dysfunction commonly. Patients＆39; confidence, generally recovery and slight or mild complication were the important influence factors for poor sexual function of patients, while age, occupation, clinical stage, income, medical history, chemotherapy or personal attention on sexual function had no significant effects on sexual function.

关 键 词：鼻咽肿瘤/放射疗法 性功能障碍 

分 类 号：R739.6[医药卫生—肿瘤]