摘要
目的:探讨认知和行为治疗改善慢性肾衰肾移植术后的性功能和生活质量的可能性。方法:选择2001-01/2004-06在抚顺市中心医院泌尿外科行肾移植手术后出院患者97例,根据自愿原则分为治疗组(n=51)和对照组(n=46)。治疗组于出院后的6个月内进行认知行为治疗治疗组每15～20d治疗1次,疗程6个月。对照组不进行认知和行为治疗。治疗前后分别以男性性功能电脑测评系统和国际性功能评估量表评估两组男、女性患者的性功能,以诺丁汉健康量表评估两组患者的生活质量。结果:按意向处理,97例患者各量表评分均进入结果分析。①男性患者性功能电脑测评系统评分比较:治疗组治疗后性欲减退(38.6±11.7)、勃起功能障碍(36.7±14.2)、性交过程焦虑(25.6±9.5)和性合作缺乏(21.4±12.5)评分均明显优于同期对照组(43.2±18.5,41.7±15.6,29.7±10.1,26.3±13.7),差异均有显著性(t=2.137～2.894,P均<0.05)。②女性患者国际性功能评估量表评分比较:治疗组治疗后性欲(183.5±31.7)、性唤起(179.7±30.4)、性高潮(192.8±34.7)和性心理(186.4±40.4)评分均明显优于对照组(172.2±55.6,171.6±37.2,164.0±40.2,170.9±36.4),差异均有显著性(t=2.224～3.060,P均<0.05)。③诺丁汉健康量表评分比较:治疗组治疗后精力(6.2±2.0)、情感(3.2±0.7)和社交活动(1.2±0.3)评分均明显优于对照组(6.8±2.5,3.6±0.9,1.7±0.2),差异均有显著性(t=2.138～3.420,P均<0.05)。结论:慢性肾功能衰竭肾移植术后患者存在着性功能障碍和生活质量较差的问题,对其进行针对性的认知和行为干预可改善不良的思维模式和行为状态。
AIM：To investigate the possibility of cognitive and behavioral therapy in ameliorating the sexual function and quality life in patients after kidney transplantation.METHODS：Ninety-eight patients after discharge, who were undertaken kidney transplantation in the Department of Urology, Fushun Central Hospital between January 2001 and June 2004, were voluntarily divided into treatment group （n=51） and control group （n=46）. Patients in the treat mentgroup received cognitive and behavioral therapy within 6 months after discharge, once every 15 to 20 days for 6 months as a course; Those in the control group did not receive the cognitive and behavioral therapy. Before and after therapy, the sexual functions of male and female patients were assessed with the male sexual function computer assessing system and the international sexual function assessment scale; The quality of life of the patients in the two .groups was evaluated with the Nottingham health profile.RESULTS：According to intention-to-treat analysis, all the 98 patients were involved in the analysis of results. ① Comparison of the scores of male sexual function computer assessing system： The scores of hyposexuality, erectile functional disorder, anxiety during sexual intercourse and deficiency in sexual cooperation after therapy in the treatment group（38.6±11.7, 36.7±14.2, 25.6±9.5, 21.4±12.5） were significantly superior to those in the control group （43.2±18.5, 41.7±15.6, 29.7±10.1, 26.3±13.7）（t=2.137 to 2.894, P 〈 0.05）. ② Comparison of the scores of international sexual function assessment scale for female patients： The scores of sexuality, sexual arousal, sexual orgasm and sexual psychology after therapy were significantly better in the treatment group （183.5±31.7, 179.7±30.4,192.8±34.7, 186.4±40.4） than in the control group （172.2±55.15,171.6±37.2,164.0±40.2,170.9±36.4） （t=2.224 to 3.060, P 〈 0.05）. ③ Comparison of the scores of Nottingham health profile： The scores of vigor, affection and social activity after therapy were significantly better in the treatment group（6.2±2.0, 3.2±0.7, 1.2±0.3） than in the control group （6.8±2.5, 3.6±0.9,1.7±0.2） （t=2.138 to 3.420, P 〈 0.05）.CONCLUSION：Patients with chronic renal failure after kidney transplantation have the problems of sexual dysfunction and worse quality of life,the cognitive and behavioral therapy aiming at the symptoms can ameliorate their bad thinking pattern and behavioral status.
出处
《中国临床康复》
CSCD
北大核心
2005年第20期57-59,共3页
Chinese Journal of Clinical Rehabilitation
