脊髓损伤对男性性功能影响的临床观察

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摘要目的探讨脊髓损伤对男性性功能的影响。方法对2017年12月至2019年5月在郑州市第二人民医院诊治的39例外伤性脊髓损伤患者进行回顾性分析。伤后所有患者均手术处理。患者均为男性；年龄28~46岁，平均年龄(37.5±5.5)岁。采用勃起功能国际指数(international index of erectile function-5，IIEF-5)评定勃起功能，神经脊髓功能则用美国脊柱损伤协会(American spinal injury association，ASIA)制定的脊髓损伤神经学分类标准进行ASIA分级、ASIA运动及感觉评分进行评价，观察脊髓损伤前后脊髓神经功能受损及性功能的影响。术后行脊髓神经功能及性功能恢复的对比研究，并对性功能障碍患者进一步测定其反射性勃起和精神性勃起的情况。结果所有患者随访时间14～31个月，平均(21.9±5.2)个月。脊髓损伤后除运动感觉受损外，性功能也同时受损，与伤前比较差异具有统计学意义(P＜0.05)。IIEF-5评分由伤前的(22.9±1.4)分降为伤后的(11.3±2.7)分，术后提高到(17.9±5.2)分。ASIA感觉评分术前为(116.9±50.0)分，术后提高到(174.6±36.0)分；运动评分术前为(60.5±14.3)分，术后提高到(83.0±13.8)分，感觉评分与运动评分均较术前明显改善，差异有统计学意义(P＜0.05)。结论外伤性脊髓损伤除导致常见的运动感觉神经功能受损外，对男性性功能有明显的影响。治疗时间、受损节段、损伤程度、恢复时间等因素对性功能障碍的程度和恢复均有影响。

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关键词 ：脊髓损伤, 性功能障碍, 随访

Abstract：Objective To investigate the impact of male sexual function by the injury of spinal cord.Methods 39 cases of traumatic spinal cord injury patients in 2nd People's Hospital of Zhengzhou from December 2017 to May 2019 were included in this retrospective research.All patients were male，aged from 28 to 46 years，with an average age of (37.5±5.5) years.All patients underwent surgery after injury.International index of ecrectile function(IIEF) was used to evaluate patients' erection function.The neurological classification of spinal cord injury developed by American Spinal Injury Association (ASIA ) and ASIA motor and sensory scores were used to evaluate the neurological function of spinal cord injury.We evaluated the impacts of neurological and sexual function before and after injury of spinal cord，compare neurological and sexual function recovery after surgery.For the patients with sexual dysfunction were examine for felex erection and psychogenic erection function.Results All patients received follow-up in a period of 14 to 31 months (mean 21.9±5.2).ASIA sensory score was (116.9±50.0)，ASIA motor score was (60.5±14.3).IIEF-5 decreased from (22.9±1.4) pre-injuryly to (11.3±2.7) post-injuryly.Aside from the Sensorimotor dysfunction，sexual function was also affected significantly after injury (P＜0.05).After surgery，IIEF-5 was (17.9±5.2)，ASIA sensory score was (174.6±36.0)，ASIA motor score was (83.0±13.8)，with significantly improved compared with which before surgery(P＜0.05).Conclusion Traumatic injury of spinal cord can make obvious impact on male sexual function，aside from sensorimotor dysfunction.Time of treatment，injury segment，damage level and time to recover affect the extent of the damage of sexual function and recovery.

Key words： spinal cord injuries sexual dysfunction follow up

作者简介: 李广伟(1975－ )，男，副主任医师，郑州市第二人民医院骨科，450000。

引用本文:

李广伟 1，王少波 2，赵文奎 3，白忠旭 1，王红军 1，孙晓智 1. 脊髓损伤对男性性功能影响的临床观察[J]. 实用骨科杂志, 2021, 27(2): 118-126.
Li Guangwei 1，WangShaobo 2，Zhao Wenkui 3，et al. Clinical Study of Spinal Cord Injury on Male Sexual Function. sygkzz, 2021, 27(2): 118-126.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2021/V27/I2/118

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