摘要
目的：探讨经阴道自然腔道内镜手术（ NOTES）辅助腹腔镜下单纯肾切除术对女性性功能和生活质量的影响。方法前瞻性观察2011年5月至2012年11月行经阴道NOTES辅助腹腔镜下单纯肾切除术患者的性功能和生活质量变化情况。本组42例，年龄26～45岁，平均（36．9±5．3）岁。体质指数14．7～27．1 kg/m2，平均（21．7±2．6）kg/m2。上尿路结石致重度肾积水、无功能肾28例，致肾积脓11例，肾结核1例，重复肾积水1例，肾血管平滑肌脂肪瘤1例。左侧24例，右侧18例。采用女性性功能指数问卷（FSFI）及健康调查简表（SF-36）对患者术前及术后4、7、12个月的性功能和生活质量进行评价。结果术前及术后4、7、12个月FSFI 分别为（27．74±4．34）分、（27．19±4．49）分、（28．54±4．23）分、（28．68±4．19）分，组间比较差异无统计学意义（F＝1．111，P＝0．346）。术后4、7个月SF-36表中生理功能、精力、心理健康、躯体疼痛和总体健康状况等维度均较术前显著改善（P＜0．05），但生理职能、情感职能、社会功能等维度改善不明显（P＞0．05）；术后12个月SF-36表各维度评分均高于术前，差异有统计学意义（ P＜0．05）。结论经阴道NOTES辅助腹腔镜下单纯肾切除术对女性性功能无负面影响；患者术后生活质量可获改善，且早期以生理质量改善为主，后期心理质量逐步改善。
Objective To investigate the impact of transvaginal natural orifice transluminal endo-scopic surgery（NOTES）-assisted laparoscopic nephrectomy on female sexual function and quality of life . Methods This was a prospective study on the change of female sexual function and quality of life of female patients who underwent transvaginal NOTES-assisted laparoscopic nephrectomy from May .2011 to Nov. 2012.A total of 42 cases were included in this study （28 of them with severe hydronephrosis , non-functio-ning kidney , 11 with pyelonephrosis , 1 with renal tuberculosis , 1 with duplex kidney complicated with hy-dronephrosis, and 1 with renal angiomyolipoma ）.The mean age was 36.9±5.3 （26-45） years, and the mean body mass index was 21.7±2.6 （14.7 to 27.1） kg/m2.Twenty-four cases were operated on the left side, 18 cases on the right .The female sexual function and quality of life were assessed before and 4 months, 7 months and 1 year after surgery using the Female Sexual Function Index （FSFI） questionnaire and the MOS 36-item Short-Form Health Survey （SF-36）, respectively. Results The mean FSFI of 42 cases preoperatively and 4 months, 7 months and 1 yr postoperatively were 27.74 ±4.34, 27.19 ±4.49, 28.54±4.23, and 28.68 ±4.19, respectively.There was no statistically significant difference among them （F=1.111, P=0.346）.Compared with that of preoperation , the physical function, vitality, metal health, body pain, and general health of the patients were improved , but the role-physical, role-emotion and social function were not improved at postoperative month 4 and month 7 （P〈0.05）.Each item of SF-36 was im-proved after postoperative 1 year （ P〈0.05） . Conclusions Transvaginal NOTES-assisted laparoscopic ne-phrectomy does not cause negative effect on the female sexual function .The quality of life can be improved after operation .The physical function is improved at early stage , and the psychological function as well .
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2014年第7期531-534,共4页
Chinese Journal of Urology
基金
国家高技术研发计划（863计划）项目（2012AA021100）
江西省“赣鄱英才555工程”领军人才培养计划项目
江西省科技厅重大科技支撑计划项目（20121BBG70032、20132BAB205007）
江西省教育厅科技落地计划项目（KJLD12044）
江西省卫生厅科技计划项目（20111074、20121095）
关键词
经自然腔道内镜手术
经阴道
女性性功能
生活质量
Natural orifice transluminal endoscopic surgery
Transvaginal
Female sexual func-tion
Quality of life
