育龄期乳腺癌术后患者性功能障碍状况及其影响因素研究

Female sexual dysfunction among postoperative patients with breast cancer at childbearing age

目的了解育龄期女性乳腺癌患者术后性功能障碍发生现状,探讨女性性功能障碍(FSD)相关影响因素。方法采用便利抽样的方法,选取2017-02-01-2018-02-28安徽医科大学第一附属医院收治的249例乳腺癌术后患者(术后时间>2周)为研究对象,采用一般资料调查表、女性性功能指数量表(FSFI)、社会支持量表及体像量表对患者进行调查。采用EpiData3.1进行数据录入,SPSS16.0进行数据分析。采用独立样本t检验或χ^(2)检验比较FSD患者和非FSD患者之间一般情况分布差异,Spearman相关分析探讨FSD与社会支持量表、体像量表的相关性,采用Logistic回归分析探讨FSD的影响因素。结果 FSFI总分为(21.38±8.12)分,FSD总发生率为62.2%。除性欲望障碍维度与对支持的利用度维度之间无相关性外(r;=0.113,P=0.074),乳腺癌患者总FSD及各维度障碍与社会支持总分及各维度之间均存在正相关,均P<0.05。乳腺癌患者的总FSD及各维度障碍与体像量表总分及各维度之间均呈负相关,均P<0.05。术后时间(OR=0.212, 95%CI为0.063~0.715,P=0.012)、未接受内分泌治疗(OR=0.334, 95%CI为0.149~0.749,P=0.008)和社会支持(OR=0.213, 95%CI为0.074~0.612,P=0.004)是FSD的保护因素,未接受过性生活专业指导(OR=5.409, 95%CI为2.233~13.103,P<0.001)、术后第一次性生活时间(OR=11.256, 95%CI为1.761~71.941,P=0.011)及体像水平(OR=22.920, 95%CI为1.866~281.580,P=0.014)是FSD的危险因素。结论育龄期乳腺癌术后患者FSD发生率较高,术后时间、内分泌治疗、性生活专业指导、术后性生活恢复时间、社会支持及体像水平等因素可能是FSD的影响因素。

Objective To investigate the prevalence and risk factors of female sexual dysfunction(FSD) among postoperative patients with breast cancer at childbearing age. Methods A convenient sampling method was conducted in a third-grade class-A hospital of Anhui province, and 249 paitients who were recruited from the department of tumor and radiation therapy diagnosed as postoperative of breast cancer patients at childbearing age(postoperative time >2 weeks) from February 2017 to February 2018. They were investigated by the general information questionnaire, Female Sexual Function Index(FSFI), Social Support Rating Scale(SSRS) and Body Image Scale(BIS). EpiData 3.1 software and SPSS 16.0 software were adopted. The incidence of FSD in patients with different characteristics were compared by two independent samples t-test or χ^(2) test. Spearman’s correlation analysis was used to explore the relationship between the incidence of FSD and the level of social support and body image. The logistic regression analysis was carried out to explore the protective factors and risk factors of FSD. The value less than 0.05 was considered to be statistically significant. Results The total score of FSFI in the patients with breast cancer was 21.38±8.12. The overall prevalence of FSD was 62.2%. FSD and social support: there was no correlation between the dimension of sexual desire disorder and utilization of support(r;=0.113, P=0.074), however there were significant positive correlations between the total or other dimension of FSD and the total or each dimension of social support in breast cancer patients,all P<0.05.FSD and body image level:there were significant correlations between the total or each disorder dimension of FSD and the total or each dimension of BIS in breast cancer patients,all P< 0.05.Logistic regression analysis showed that the postoperative time(OR=0.212,95%CI:0.063-0.715,P=0.012),no endocrine therapy(OR=0.334,95%CI:0.149-0.749,P=0.008)and social support(OR=0.213,95%CI:0.074-0.612,P=0.004)are protective factors of FSD.No professional guidance on sexual life(OR=5.409,95%CI:2.233-13.103,P<0.001),the first sexual time after surgery(OR=11.256,95%CI:1.761-71.941,P=0.011)and body image level(OR=22.920,95%CI:1.866-281.580,P=0.014)were risk factors of FSD.Conclussions The prevalence of FSD is higher in patients with breast cancer at childbearing ageis.The factors such as postoperative time,endocrine therapy,professional guidance of sexual life,recovery time of postoperative sexual life,the level of social support and body image may be influencing factors of FSD.