中青年妇女子宫全切术后性生活质量影响因素分析

Investigation of qulity of sexual life and its impact factors in young females patients who have hysterectomy

目的 调查中青年妇女全子宫切除术后性生活质量,分析影响性生活质量的相关因素.方法 回顾性分析山西省肿瘤医院2009年11月至2011年11月子宫全切除术后199例患者,进行一般情况、术后日常生活情况及性生活质量方面随访调查,调查数据采用Stata 9.1统计分析软件,对影响患者性生活生存质量的相关性因素行Logistic回归分析.结果 患者年龄、职业、学历、术后时间、所患疾病及合并疾病对子宫全切术后患者的性生活质量具有一定的影响（均P＜ 0.05）.年龄在41 ～ 50岁和51～60岁患者生活质量的满意度显著高于年龄≤40岁患者（OR=3.8,95％CI.36～10.66; OR=3.6,95％CI 1.24～ 10.43）;服务行业患者、工人患者和自由职业者的满意度较农民患者均降低（OR=0.46,95％CI0.12～ 1.75;OR =0.75,95％CI0.27～2.12;OR=0.94,95％CI 0.45～ 1.98）;而行政工作者和知识分子的满意度提高（OR=1.11,95％CI 0.34 ～ 3.62;OR=1.33,95％CI 0.35 ～5.10）;把小学学历患者作为参照进行比较,除大专及其以上学历患者性生活质量的满意度高于小学学历患者外（OR=1.15,95％ CI0.43 ～ 3.04）,初中、高中和中专患者的满意度均降低（OR=0.98,95％CI 0.46 ～ 2.11;OR=0.63,95％CI0.26～ 1.54;OR=0.15,95％CI0.02 ～ 1.27）;手术后7～12个月、13 ～ 24个月、24个月以上患者较术后6个月内患者满意度提高（OR=1.94,95％CI 0.65～5.83; OR=6.32,95％CI 2.17 ～ 18.38; OR=8.47,95％CI 2.92～ 24.56,趋势P＜ 0.001）.结论 应重视术前术后相关知识的宣教,因人施教,让患者及其配偶掌握一定的女性生理常识,充分认识该术式对患者性生活的影响程度,对提升患者的自信心、改善患者性生活质量有积极意义.

Objective To investigate sexual life associated with hysterectomy of young women and its related factors.Methods Data from 199 patients with hysterectomy were collected.Statistical analysis was performed between the postoperative recovery condition among them,including daily life and sex life.Results There was significant difference on sexual life quality of the patients by hysterectomy among patient age,occupation,education,postoperative time,disease and complication （P 〈 0.05）.The age of 41-50 years and 51-60 years old patients＇ quality of life satisfaction was significantly higher than that of age ≤40 years old patients （OR =3.8,95 % CI 1.36-10.66; OR =3.6,95 % CI 1.24-10.43）.The patients of the occupation of service sectors,workers,and patients with free occupation have a decreased satisfactions compared with that of farmer patients （OR =0.46,95 % CI 0.12-1.75; OR =0.75,95 % CI 0.27-2.12; OR =0.94 95 % CI 0.45-1.98）.There was a increasing satisfactions in administrative and the intellectuals （OR =1.11,95 % CI 0.34-3.62; OR =1.33,95 % CI 0.35-5.10）.Patients with primary school educations as a reference for comparison,the quality of life of patients with associated college and above degree were increased than patients with primary school （OR =1.15,95 % CI 0.43-3.04）,and were decreased in the patients of the high and middle school （OR =0.98,95 % CI 0.46-2.11; OR =0.63,95 % CI 0.26-1.54; OR =0.15,95 % CI 0.02-1.27）.The quality of life satisfaction of long period patients （7-12 months,13-24 months,24 months after the operation）was significantly higher than that of short period patients with 6 months（OR =1.94,95 % CI 0.65-5.83; OR =6.32,95 % CI 2.17-18.38; OR =8.47,95 % CI 2.92-24.56,P 〈 0.001）.Conclusion The doctors need focus on relative knowledge education of perioperation.It is important to inform patients and their spouses to have the knowledge of female physiology,fully understanding the impact of the extent of surgery on sexual life of patients to enhance the confidence and improve the life quality of patients.