全直肠系膜切除术中保留盆腔自主神经对男性患者性功能影响的临床研究  

Clinical effect of pelvic autonomic nerve preservation in total mesorectal exeision surgery on male sexual function

作　　者：谢京典 徐慧杰[1] 管永俊[2] XIE Jingdian XU Haijie GUAN Yongjun(Department of General Surgery, Zaoyang First People＇ s Hospital, Xiangyang 441200, Hubei, China Department of Urology, Xiangyang Central Hospital, Xiangyang 441021, Hubei, China)

机构地区：[1]枣阳市第一人民医院普外科,湖北襄阳441200 [2]襄阳市中心医院泌尿外科,湖北襄阳441021

出　　处：《中国性科学》2016年第12期44-46,共3页Chinese Journal of Human Sexuality

摘　　要：目的:探讨全直肠系膜切除术中保留盆腔自主神经对男性患者性功能影响性,以期选择最佳手术方式,提高临床诊治水平。方法:选取2010年1月至2013年1月86例需进行全直肠系膜切除术患者为研究对象,分成两组,对照组43例,予传统的手术治疗,观察组43例,全直肠系膜切除术保留盆腔自主神经治疗,观察治疗后相关指标变化。结果:对照组在勃起功能上Ⅰ级、Ⅱ级、Ⅲ级发生率分别为23.26%、51.16%、25.58%,勃起功能基本正常率74.42%,观察组勃起功能上Ⅰ级、Ⅱ级、Ⅲ级发生率分别为48.84%、48.84%、2.33%,勃起功能基本正常率97.67%,两组治疗后比较差异有统计学意义(P<0.05);对照组在射精功能上Ⅰ级、Ⅱ级、Ⅲ级发生率分别为27.91%、44.18%、27.91%,总射精发生率72.09%,观察组射精功能上Ⅰ级、Ⅱ级、Ⅲ级发生率分别为48.84%、41.86%、9.3%,总射精发生率91.7%,两组治疗后Ⅰ级、Ⅲ级和总射精发生率比较差异有统计学意义(P<0.05);两组治疗后3、6、12个月在IIEF评分上较治疗前比较均明显下降,治疗前后比较差异有统计学意义(P<0.05),治疗后3、6、12个月两组间IIEF积分比较均有统计学意义(P均<0.05)。结论:全直肠系膜切除术中保留盆腔自主神经有助于男性性功能恢复。Objectives： To investigate the effect of pelvic autonomic nerve preservation in total mesorectal exeision（ TME） surgery on male sexual function so as to choose the best surgical approach to improve clinical diagnosis and treatment. Methods： 86 patients who received TME surgery from January 2010 to January 2013 were divided into two groups. Control group（ 43 patients） received traditional surgical treatment and observation group（ 43cases） received TME with preservation of pelvic autonomic nerve treatment. Related indicators changes after treatment were observed. Results： In control group,occurrence rates of erectile function grade I,grade II and grade III were 23. 26%,51. 16% and 25. 58%,and the normal erectile function rate was 74. 42%. In the observation group,occurrence rates of erectile function grade I,grade II and grade III were 48. 84%,48. 84% and 2. 33%,and the normal erectile function rate was 96. 67%. The difference was statistically significant（ P〈0. 05）. In control group,occurrence rates of ejaculatory function grade I,grade II and grade III were 27. 91%,44. 18% and27. 91%,and the total incidence of ejaculation was 72. 09%. In observation group,occurrence rates of ejaculatory function grade I,grade II and grade III were 48. 84%,41. 86% and 9. 3%,and the total incidence of ejaculation was 91. 7%. The difference in total ejaculation rates in two groups was statistically significant（ P〈0. 05）; 3,6,12 months after treatment,the IIEF scores were significantly decreased comparing with that before treatment with statistically significant difference（ P〈0. 05）. 3,6,12 months after treatment,the difference in IIEF integration between the two groups was statistically significant（ P〈0. 05）. Conclusion： Pelvic autonomic nerve preservation in TME surgery helps restore male sexual function.

关 键 词：全直肠系膜切除术 盆腔自主神经 性功能 

分 类 号：R61[医药卫生—外科学]