摘要
背景:直肠癌术后男性性功能和排尿功能障碍有较高的发生率,患者年龄和手术方式是有可能造成性功能障碍和排尿功能障碍的主要原因。而随着外科技术和患者要求的提高,保护患者性功能和排尿功能已成为研究热点。目的:探讨不同年龄,不同手术方式对男性直肠癌患者性功能和排尿功能的影响。设计:以患者为研究对象的调查研究。单位:解放军总医院第三○九临床部普通外科。对象:以解放军总医院第三○九临床部1990-01/2000-10收治的男性直肠癌为研究对象。纳入本实验的患者79例。均接受直肠癌根治性手术,术前性功能和排尿功能均正常,并接受2年以上随访者。两组不同手术患者的样本量,年龄段基本相同,具有可比性。方法:通过发随访信,门诊及电话随访患者术后性功能:包括阴茎勃起和射精;勃起功能按国际指数问卷调查评价。射精功能以能否达性高潮及能否射精为标准。排尿功能:包括近期排尿功能和远期排尿功能。主要观察指标:不同年龄段直肠癌手术后,患者的性欲,勃起功能,射精功能和排尿功能。结果:Miles术性功能障碍81%。近期排尿功能障碍46%(19/41),远期排尿功能障碍5%(2/41)。Dixon术性功能障碍55%。近期排尿功能障碍29%(11/38),无远期排尿功能障碍。两术式相比,差异有显著性意义(P<0.05)。各年龄段性功能障碍。
BACKGROUND:The occurrence of sexual and urinary dysfunction is higher in patie nts who have received rectal cancer surgeries.This could most likely be correlat ed with the age of the patients and the approach applied in the operation.Theref ore,how to preserve the sexual and urinary functions has become a hot point in t his field. OBJECTIVE:This study was designed to investigate the influence of differences in age and therapeutical approach on the sexual and urinary function in patients with rectal cancer. DESIGN:Investigation study on patients. SETTING:General Surgery Department, the 309 Clinical Division,General Hospital of Chinese PLA. PARTICIPANTS:Some male patients with rectal cancer hospitalized in the General Surgery Department, the 309 Clinical Division,General Hospital of Chinese PLA w ere involved from January 1999 to October 2000.All of the 79 eligible patients h ad received a radical surgery for rectal cancer by the time of study.Their sexua l and urinary function before surgery were normal and an over 2 year follow u p after surgery was conducted on each of them. The two groups,which were classif ied into two groups according to surgical approaches they received,contained com parable quantity of sampling and age distributions,which prompts the validity of the comparison. METHODS:By distributing follow up letters,outpatient inquiries and phone call investigations;the follow up was conducted to evaluate the sexual functions in these patients, including their penile erection and ejaculation.The erectile fu nction was assessed according to the International Index of Erectile Function Qu estionnaire 5(IIEF 5).The assessment on ejaculation was based on whether the p atients had a sexual climax and whether they can ejaculate.The definition of uri nary function consisted of both short term and long term urinary functions. MAIN OUTCOME MEASURES:The sexual desire,erectile function, ejaculation and the urinary function in patients within different age brackets. RESULTS:After Miles operation, 81%patients developed sexual dysfunction,46%g ot short term urinary dysfunction(19/41) and 5 %( 2/41) had long term urinary dysfunction.While after Dixon operation, 55%patients had sexual dysfunction,29 %(11/38) had short term urinary dysfunction,and none of the patients had long term urinary dysfunction.The difference between the outcomes of the two operat ions was significant(P< 0.05). Sexual dysfunction occurred at a rate of 38%in the less than 40 age bracket,60%in the 40 to 59 age bracket,and 96%in the over 60 age bracket.The overall differences between different pairs of age bra ckets were significantly(P< 0.05). CONCLUSION:There is a high rate of postoperative sexual and urinary dysfunctio n in male population.The age of patients and the approach adopted in the surgery are directly correlated with the rate of dysfunction.An autonomic nerve preser ving radical operation for rectal cancer can reduce the occurrence of sexual and urinary dysfunction effectively.
出处
《中国临床康复》
CSCD
北大核心
2005年第14期200-201,共2页
Chinese Journal of Clinical Rehabilitation
