62例男性外伤性脊髓损伤患者性功能障碍及生活质量调查分析

Sexual dysfunction and quality of life after spinal cord injury

目的对因工伤致脊髓损伤（SCI）的男性患者进行性功能障碍状况问卷调查，并进行生活质量（QOL）评定，以期全面了解男性工伤SCI患者性功能障碍的特点、性康复治疗情况及生活质量状况。方法采用国际勃起功能指数表（11EF-5）、自行设计的性功能综合调查表及世界卫生组织生活质量简表（WHOQOL．BREF）对62例男性工伤SCI患者进行了有效问卷调查，并与同期住院的146例工伤伤残患者的WHOQOL—BREF量表问卷得分进行了单样本t检验统计比较。结果本组患者77．9％存在中、重度勃起障碍，半数以上仍存在性欲和性需求，有52．7％曾尝试过性交，能完成者仅占19．5％，仅14．5％伤后获得过性满足。69．1％的SCI患者伴有心理症状，27．27％存在家庭问题，WHO—QOLEF简表平均得分低于工伤伤残患者（P〈0．05），尤其在生理、社会关系方面的得分更低（P〈0．01），生活质量显著下降。结论男性SCI患者普遍存在性功能障碍，整体生活质量处于较低水平，而国内SCI性功能障碍康复工作严重滞后。医疗卫生和劳动保障部门应加强对SCI患者性功能障碍相关问题的关注，对工伤SCI患者应常规进行性功能检查和性康复教育，将性功能障碍康复治疗费用纳入工伤保险支付范围。

Objective To investigate sexual dysfunction and its rehabilitation, as well as quality of life in patients after spinal cord injury （SCI）. Methods Sixty-two male patients with SCI were assessed with a 5-item version of the International Index of Erectile Function （IIEF-5） , an especially-designed sexual function scale, and the World Health Organization＇s quality of life questionnaire （WHO-QOL）. Their results were compared with those of 146 other patients with work injuries hospitalized in the same period. Results 77.9% of 62 cases had moderate to severe erectile dysfunction, though more than half of them remained sexually active. 52.7% had attempted sexual in- tercourse, but only 19.5% succeeded, and rmly 14. 5% obtained sexual satisfaction. 69. 1% of the 62 patients had psychological symptoms, and 27.27% had f^-nily probl, ~s. Their average score on the WHO-QOL was significantly lower than that of the other disabled workers. There were significant differences between the two groups with regard to quality of life, especially in the physiological and social relationships domains. Conclusion Most male patients with SCI had sexual dysfunction and decreased quality of life. Sexual dysfunction rehabilitation of SCI patients needs urgent strengthening.