不同术式前列腺增生症患者性激素水平及性功能变化探究.docVIP

不同术式前列腺增生症患者性激素水平及性功能变化探究 　 作者：张英杰，张彦选△，张会清，李建昌，余沁楠，刘 沛 【摘要】 目的 研究行SPP、TURP、TUBVP的病人手术前后性激素水平及性功能变化情况；探讨性激素水平变化与手术方式、术后性功能障碍三者间的关系。方法 （1）选取200例BPH病人，每例病人分别于术前及术后3个月利用勃起功能中国指数（CIEF）量表来判定性功能状态；（2）SPP组（40例）、TURP组（80例）、TUBVP组（80例）按入院时间以1∶2∶2的比例随机录用。（3）所有病人于术前2天、术后1周及术后3个月分别于上午9～10时抽血，经离心后得到血清样本，分别以T、FSH、E2、LH、PRL放射免疫分析测定盒测定各自的浓度。结果 所有病人的性激素水平都发生了变化，以术后1周T的降低，LH和PRL的升高最明显，到术后3个月时性激素水平恢复正常；发生性功能障碍者有24例。结论 前列腺手术可引起性激素水平的变化，性激素水平变化与术后性功能障碍的发生无关；但手术方式与性功能障碍的发生有关，TUBVP术后并发性功能障碍率低，对于前列腺的手术治疗，TUBVP优于SPP和TURP。 【关键词】 手术；性激素；性功能障碍；良性前列腺增生症 【Abstract】 Objective To study the alternation of the serum levels of sexual hormone and sexual function following the SPP，TURP，TUBVP；and to evaluate the relationship among the alternation of the serum levels of sexual hormone， the style of operation and the sexual dysfunction after operation.Methods 200 cases of BPH which had normal sexual function before operation were chosen and divided randomly (1：2：2 in accordance with the time of hospitalization) into three groups：SPP group(40 cases)，TURP group(80 cases)，TUBVP group(80 cases). The sexual function state of patients were assessed by CIEF(Chinese Index of Erectile Function -5 ) at 2 days before operation and 3 months after operation.All patients were drawn blood at 9~10Am of 2 days before operation and 1 week，3 months after operation.The serum concentration of T，FSH，LH，PRL，E2 were determined by immunoradioassay kit after the blood were centrifuged.Results All cases have the alternation of the serum levels of sexual hormone. It is more significant to the descent of T， the increase of LH and PRL in 1 week after operation. 24 cases have sexual dysfunction after operation.Conclusion The operation of prostate can cause the alternation of the serum levels of sexual hormone which do not have relationship with sexual dysfunction. But the styles of operation have relationship with sexual dysfunction.TUBVP with the little influence on the alternation of sexual hormone and lower incidence of sexual d