【作者】 周任远；

【导师】 王国民；

【作者基本信息】 复旦大学 ， 外科学， 2011， 硕士

【摘要】 目的：探讨不同病理类型垂体腺瘤男性患者性功能障碍的发病特征及其影响因素。方法：回顾性分析我院2006年6月至2008年12月期间收治的86例男性垂体腺瘤患者术前资料,通过问卷调查获得患者手术前的性功能(IIEF5、性欲和射精功能)情况。分析性功能障碍与年龄、病理类型、侵袭性、大小、血清泌乳素及睾酮水平的相关性。结果：1.全部86例男性垂体腺瘤患者中69例(80.2%)有性功能障碍。功能性垂体腺瘤78例,其中66例(84.6%)有性功能障碍；无功能性垂体腺瘤患者8例,其中3例(37.5%)有性功能障碍。结果显示功能性垂体腺瘤组性功能障碍的发生率明显高于无功能性垂体腺瘤组,两组性功能障碍发生率存在显著性差异(P<0.05)。2.功能性垂体腺瘤患者中,泌乳素腺瘤组(PRL组)ED有92.1%(35/38),性欲低下84.2%(32/38),射精障碍76.3%(29/38)。促性腺激素腺瘤组(FSH组)中ED有69.7%(16/23),性欲低下78.3%(18/23),射精障碍65.2%(15/23)。生长激素腺瘤组(GH组)中ED有70.6%(12/17),性欲低下52.9%(9/17),射精障碍41.2%(7/17)。将三组的性功能逐一比较,结果显示,PRL组ED的发生率明显高于FSH组和GH组(P<0.05)。而GH组性欲低下和射精功能障碍的发生率明显低于PRL组和FSH组(P<0.05)。3.用Logistic回归分析,分析性功能障碍与年龄、病理类型、侵袭性、大小、血清泌乳素及睾酮水平的相关性。结果显示,勃起功能障碍、性欲低下、射精功能障碍均与垂体腺瘤类型存在显著的相关性(P<0.05),而与年龄、肿瘤大小、侵袭性、血清泌乳素及睾酮水平无明显相关性(P>0.05)。结论：1.男性功能性垂体腺瘤组性功能障碍发生率明显高于无功能性腺瘤组。2.男性功能性垂体腺瘤组中,PRL组性功能障碍以ED为主要临床表现,GH组性欲低下和射精功能障碍的发生率都较FSH组和PRL组低。3.垂体腺瘤的病理类型是男性患者性功能障碍的主要影响因素。更多还原

【Abstract】 Objective:To discuss the clinical feature and related factors of sexual dysfunction in the male patients with pituitary adenomas.Methods:We reviewed medical records of 86 male patients with pituitary adenomas and collected questionnaires about sexual function retrospectively, then analyzed the correlations between sexual behavior and age, tumor type, invasion, tumor size, serum prolactin, serum testosterone.Results:69(80.2%) and 3(37.5%) sexual dysfunction were found in 78 patients with functioning pituitary adenomas and in 8 patients with Non-functioning pituitary adenomas, respectively. In the functioning pituitary adenomas groups, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 92.1%(35/38) and 84.2%(32/38) and 76.3%(29/38) in PRL group, respectively. In the FSH group, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 69.7%(16/23) and 78.3%(18/23) and 65.2%(15/23), respectively. In the GH group, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 70.6%(12/17) and 52.9%(9/17) and 41.2%(7/17), respectively.Conclusions The incidence of sexual dysfunction in the males with functioning pituitary adenomas was higher than in the males with Non-functioning pituitary adenomas. In the functioning pituitary adenoma groups, erectile dysfunction was the most important symptom in PRL group and the incidence, either reduced sexual desire or ejaculation dysfunction, in GH group was lower than in PRL group and FSH group. Pathology of the pituitary tumors was the main risk factor to result in sexual dysfunction.更多还原