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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 investigate the postoperative sexual function of male patients with nasopharyngeal carcinoma and analyze the influencing factors. Methods The cases of nasopharyngeal carcinoma diagnosed in our hospital Tongji Hospital of Huazhong University of Science and Technology since March 2008 were collected and the sexual function before and after radiotherapy was investigated by O’Leary (1995) male sexual function scale. Some patients with follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) levels. Results Fifty-two patients with nasopharyngeal carcinoma had a rate of 34.69% (17/49) of new dysfunction after radiotherapy. Sexual desire, erection, ejaculation, perception and total satisfaction during sexual function were significantly decreased (P <0.05). Sexual dysfunction was closely related to the patient’s confidence in the prognosis of the disease and the recovery of the body after radiotherapy (P <0.05), and was closely related to the patients’ misperception, negative attitude and the severity of the side effects of the treatment (P <0.05), but not with age, occupation, educational level, income, past medical history, alcohol and tobacco and other bad habits, clinical stage, treatment and sexual function. 21 cases of nasopharyngeal carcinoma patients were collected at different time points after radiotherapy serum test hormone levels found serum FSH and LH concentrations were greater than the lower limit of normal, 1 case of serum T concentration less than <1.75ng / mL, the rest were greater than the lower limit of normal . Conclusions The incidence of sexual dysfunction in patients with nasopharyngeal carcinoma after radiotherapy is significantly higher than that before radiotherapy. Radiotherapy and related side effects are the main factors affecting sexual function. Confidence in the diagnosis and treatment of disease, cognitive attitude toward disease and sexual life, and body recovery after radiotherapy are also important factors that affect sexual function. However, age, education level, income, occupation, disease stage, induction and concurrent chemotherapy, Concern about sexual function has nothing to do with the incidence of sexual dysfunction.