摘要
目的:探讨腰椎疾患对男性性功能的影响和心理干预治疗的效果。方法:157例伴有性功能障碍的男性腰椎疾患患者分为单纯腰椎疾患组(82例,A组)和继发马尾神经综合征组(75例,B组),治疗前填写国际勃起功能指数评分表(IIEF-5)、艾森克个性问卷(EPQ),同时行球海绵体肌反射(BCR)、坐骨海绵体肌反射(ICR)、阴茎背神经体感诱发电位(SSEP)潜伏期、波幅的检测。A组患者分为对照组和心理干预组;B组患者经临床分为早、中、晚期后再分为对照组和心理干预组。对照组均给予手术治疗,心理干预组除了手术治疗外,同时给予心理干预治疗。治疗后再次采用IIEF-5和BCR、ICR、SSEP检测,并与治疗前进行统计比较。结果:A组患者性功能障碍主要为轻度勃起功能障碍(ED),而B组患者主要为重度ED。A组患者BCR、ICR、SSEP检测结果同正常值相比无显著性差异(P>0.05);心理干预组IIEF-5评分较对照组显著提高(P<0.05)。B组患者中,轻度ED患者潜伏期较正常值和A组延长(P<0.05),中度ED和重度ED患者潜伏期延长更加明显(P<0.05);处于临床早期的患者心理干预治疗组性功能的改善情况好于对照组(P<0.05),但是处于临床中、晚期的患者治疗组与对照组的差异不明显(P>0.05)。结论:单纯腰椎疾患及临床早期马尾神经综合征患者性功能障碍的发生主要受心理因素的影响,而中晚期马尾神经综合征患者以神经功能损伤为主。心理治疗能够改善单纯腰椎疾患及临床早期马尾综合征患者的性功能,对处于临床中、晚期的马尾神经综合征患者效果不明显。
Objective：To explore the correlation between erectile dysfunction and the lumbar diseases and investigate the effect of the psychologic treatment.Method： 157 male patients with lumbar disease who had sexual dysfunction were included in this study.Of which 82 cases were simple lumbar disease while 75 cases were cauda equina sndronme.Two structured questionnaires（IIEF-5 and EPQ） were investigated,and bulbo-caveruosus reflex （BCR）,ischiocavernosus reflex （ICR）,and the latency and amplitude of somatosensory eyoked potentials（SSEP） of dorsal nerve of penis were determined for all patients.82 patients with the simple lumbar disease were divided into the control and treatment group.75 patients with cauda equina syndrome（CES） were also divided into the control and treatment group depending on their clinical stage.The control group were treated with operation,and the treatment group were treated with both operation and psychotherapy.Result： were analyzed by comparing IIEF-5,BCR,ICR,SSEP between two groups.Result：The sexual dysfunction of patients with the simple lumbar disease were concentrated in the mild erectile dysfunction （ED）,but patients with CES were concentrated in the severe ED.The results of BCR,ICR and SSEP in the simple lumbar disease showed no eminent differences comparing with the normal values（P〉0.05）.The IIEF-5 scores of the psychotherapy group was significantly higher than the control group （P〈0.05）.Latency in CES with the mild ED was prolonged as comparing with the normal value and the patients with lumbar disease （P〈0.05）,the latency in CES with the moderate ED and the severe ED was significantly prolonged.The sexual dysfunction in patients with CES at early clinical stage got more improvement in the combined psychologic treatment group than the control group,but no significance difference was showed in patients at middle or late stage（P〉0.05）. Conclusion：The sexual dysfunction in the patients with the simple lumbar disease and the early CES is main ly related to psychological factors,but patients with the CES in the middle or late stage is primarily duo to injury of neural function.It can be improved by psychologic treatment in the patients with the simple lumbar disease and the early CES ,rather than in the patients with the CES in the middle or late stage.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2008年第12期900-904,共5页
Chinese Journal of Spine and Spinal Cord
关键词
腰椎疾患
马尾神经综合征
性功能障碍
电生理学
Lumbar disease
Cauda equine syndrome
Sexual dysfunction
Electrophysiology
