不同直腸癌手術術式男性患者術前術后勃起功能狀況調查分析

唐孝良 羅曉輝 尚立絨

【摘要】目的：探討不同直腸癌手術術式對男性患者術前術后勃起影響，以期提高臨床診治水平。方法：選取2010年2月至2014年2月176例直腸癌患者為研究對象，分成兩組，對照組88例，予開腹直腸癌根治術，觀察組88例，予腹腔鏡治療，觀察治療前后在勃起及射精功能的變化情況。結果：在勃起和射精功能上，術前比較差異無統計學意義（P>0.05），對照組治療后6個月、12個月和治療前比較射精功能均有下降，但治療后6個月與治療前后比較差異無統計學意義，治療后12個月和治療前比較差異有統計學意義（P <0.05），觀察組治療前和治療后6個月、12個月比較差異無統計學意義（P均>0.05）；對照組治療后6個月、12個月較治療前IIEF-5評分有下降，治療前后比較差異有統計學意義（P均<0.05），觀察組治療前和治療后6個月、12個月 IIEF-5評分比較差異無統計學意義（P均>0.05），治療后6個月、12個月兩組IIEF-5評分比較差異有統計學意義（P <0.05）。對兩組治療前后射精功能進行比較，術前比較差異無統計學意義（P >0.05）。結論：腹腔鏡根治術對直腸癌術后性功能影響性較低，總體上能改善生活質量。

【關鍵詞】 直腸癌；開腹；腹腔鏡；勃起

Investigation and analysis of different colorectal cancer surgical procedures on preoperative and postoperative male erectile functionTANG Xiaoliang1， LUO Xiaohui2， SHANG Lirong1. 1. Department of Anus & Intestine Surgery， Baoji Central Hospital， Baoji 721008， Shaanxi， China； 2. Department of Urology， Baoji Central Hospital， Baoji 721008， Shaanxi， China

【Abstract】Objectives： To study the impact of different colorectal cancer surgical procedures on preoperative and postoperative male erectile function in order to improve the clinical diagnosis and treatment. Methods： Colorectal cancer patients from February 2010 to February 2014 were enrolled in this study and divided into two groups. The control group had 88 cases and received open radical resection. Observation group had 88 cases and received laparoscopic surgery. Changes in erectile function and ejaculation before and after treatment were observed. Results： On erectile and ejaculatory function， the difference between two groups was not statistically significant （P>0.05）. Ejaculatory function of control group 6 months after treatment and 12 months after treatment were decreased comparing with that before treatment. Ejaculatory function 6 months after treatment had no significant difference comparing with that before treatment P>0.05）. Ejaculatory function 12 months after treatment had significant difference comparing with that before treatment （P<0.05）. The differences in ejaculatory function before treatment， 6 months after treatment and 12 months after treatment in observation group were not statistically significant （P>0.05）. IIEF-5 scores of control group 6 months and 12 months after treatment decreased comparing with that before treatment， with statistically significant difference （P<0.05）. Compared with the IIEF-5 score before treatment， differences in IIEF-5 score 6 months after treatment and 12 months after treatment in observation group were not statistically significant （P> 0.05）. The difference in IIEF-5 scores 6 months and 12 months after treatment was statistically significant （P<0.05）. The difference in ejaculatory function before and after treatment was not statistically significant （P>0.05）. Conclusion： Laparoscopic resection of colorectal cancer has less effect on sexual function， which can improve the quality of life in general.

【Key words】Colorectal cancer； Laparotomy； Laparoscopy； Erection

【中圖分類號】R698【文獻標志碼】A

直腸癌是臨床上較常見的癌癥，且目前日趨年輕化，外科手術是目前主要治療方式。目前達到共識的是遵循保留盆腔自主神經和全直腸系膜切除。但如何既保證根治效果又能最大限度保留患者性功能是現代直腸癌外科研究重點和熱點[1]。本次研究就通過觀察開腹和腹腔鏡治療直腸癌對患者勃起的影響，以期選擇最佳的治療方法，提高患者術后的生活質量。

1資料與方法

1.1臨床資料

選取2010年2月至2014年2月176例直腸癌患者為研究對象，分成兩組。對照組88例，平均年齡（45.1±4.5）歲；平均病程（5.1±1.1）個月；腫瘤部……