肝移植受者术后性功能调查及其影响因素分析

Investigation on sexual function of recipients after liver transplantation and impact factors analysis

目的探讨肝移植受者术后性功能状况及其影响因素。方法回顾性研究2007年7月至2012年7月在中山大学附属第三医院肝移植中心接受肝移植的69例受者临床资料。所有受者均签署由医院伦理委员会批准的知情同意书，符合医学伦理学规定。受者均为男性；年龄30～55岁，中位年龄43岁；患病前性功能均正常。采用自制“肝移植受者性生活状况问卷调查表”和直接询问相结合的方式对受者进行调查。根据肝移植术后有否发生性功能障碍将受者分为性功能障碍组（23例）和性功能正常组（46例）。分析受者性功能障碍与临床参数的关系。两组率的比较采用χ2检验。结果69例肝移植受者术后性功能障碍发生率为33%（23/69），明显低于术前的88%（61/69）（χ^2=7.56， P〈0.05）。原发病为慢性重型肝炎及肝硬化（失代偿期）的受者术后性功能障碍发生率为49%（17/35），明显高于肝硬化（代偿期）及肝脏炎性肉芽肿受者的18%（6/24）（χ^2=4.52，P〈0.05）；认为性生活会对移植肝产生不良影响的受者术后性功能障碍发生率为83%（20/24），亦明显高于认为无影响的受者的7%（3/45）（χ^2=11.63，P〈0.05）。结论肝移植受者术后性功能较术前明显改善，性功能障碍的发生与原发病及受者对性生活的认知密切相关。

Objective To investigate the sexual function and its impact factors in recipients after liver transplantation （LT）. Methods Clinical data of 69 recipients undergoing LT in Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University from June 2007 to July 2012 were analyzed retrospectively. The informed consents of all recipients were obtained and the ethical committee approval was received. All the recipients were male with age ranging from 30 to 55 years old and a median of 43 years old. The sexual function was normal in all patients before being diseased. The recipients were surveyed using self-designed questionnaire on sexual life quality of liver transplant recipients and direct inquiry. The recipients were divided into sexual dysfunction group （n=23） and intact sexual function group （n=46）. The correlation between sexual dysfunction and clinical indexes of the recipients was analyzed. The ratio of two groups was compared by Chi-square test. Results The incidence of sexual dysfunction of liver transplant recipients after operation was 33% （23/69）, which was significantly lower than that before operation [88% （61/69） ] （χ^2=7.56, P〈0.05）. The incidence of sexual dysfunction after operation in recipients with chronic severe hepatitis and decompensated liver cirrhosis [49% （17/35）] was significantly higher than those with compensated liver cirrhosis and liver inflammatory granuloma [18% （6/34）] （χ^2=4.52, P〈0.05）. The incidence of sexual dysfunction was significantly higher in recipients who considered that sexual life causing adverse impacts on the liver graft [83% （20/24）], compared with those who considered that sexual life causing no impacts on the liver graft [7% （3/45） （χ^2=11.63, P〈0.05）]. Conclusions The sexual function of the recipients after LT improved significantly, compared with that before LT. The incidence of sexual function is closely related with the primary diseases and the cognition on sexual life of the recipients.