男性不稳定性骨盆骨折患者术后继发勃起功能障碍的关联因素分析
Factors associated with erectile dysfunction after surgically treated unstable pelvic fractures in men
王力 1贾通宇 1刘凡 2贾卓 3常骁 3李毅 4王春杨 3宋涛 3张立海 4马鑫3
作者信息
- 1. 解放军总医院第三医学中心泌尿外科,北京 100039;解放军医学院,北京 100853
- 2. 解放军医学院,北京 100853
- 3. 解放军总医院第三医学中心泌尿外科,北京 100039
- 4. 解放军总医院第四医学中心骨科,北京 100142
- 折叠
摘要
背景 勃起功能障碍(erectile dysfunction,ED)是男性不稳定性骨盆骨折术后患者的主要长期并发症之一,其机制不明,探究致伤因素、骨折类型、手术因素与ED的关系对于早期识别和干预具有重要意义.目的 分析接受手术治疗的男性不稳定性骨盆骨折患者ED发生的关联因素.方法 回顾性分析 2010年 1月—2022年 12月于解放军总医院第一医学中心接受手术治疗的男性不稳定性骨盆骨折患者病历资料.采用单因素和Logistic多因素回归分析受伤年龄、受伤原因、Young-Burgess致伤因素分类、Tile分型、是否合并耻骨联合分离、是否合并外生殖器损伤、是否合并尿道损伤、创伤严重程度评分(injury severity score,ISS)、手术入路、固定材料共 10个因素与男性不稳定性骨盆骨折术后继发ED的关联性.结果 共纳入 112例男性不稳定性骨盆骨折患者,平均年龄(36.55±10.79)岁.112例中 49例(43.75%)术后发生ED.ED组与未发生ED组ISS评分(Z=-3.236,P=0.001)、是否合并耻骨联合分离(χ2=24.200,P＜0.001)、是否合并尿道损伤(χ2=22.826,P＜0.001)差异有统计学意义.多因素Logistic回归分析表明,合并尿道损伤(OR=3.765,P=0.003)、合并耻骨联合分离(OR=8.059,P=0.014)是男性不稳定性骨盆骨折术后患者继发ED的独立关联因素.结论 对于男性不稳定性骨盆骨折患者,合并尿道损伤、合并耻骨联合分离是术后康复期继发ED的重要关联因素.因此,在制定诊疗方案时应联合泌尿外科对ED进行早期识别和干预.
Abstract
Background Erectile Dysfunction(ED)is one of the main long-term complications in male patients with unstable pelvic fractures.However,its mechanism is unclear.Exploring the relationship between injury factors,fracture types,surgical factors and ED is important for early identification and intervention.Objective To analyze the correlated factors for erectile dysfunction in men with surgically treated unstable pelvic fractures.Methods A retrospective analysis was conducted on male patients with surgically treated unstable pelvic fractures at the First Medical Center of Chinese PLA General Hospital from January 2010 to December 2022.Univariate and multivariate logistic regression analysis were conducted to examine the impact of 10 factors on erectile dysfunction(ED)in men with surgically treated unstable pelvic fractures,including age of injury,trauma mechanism,Young-Burgess classification,fracture types,external genital injury,pubic symphysis diastasis,urethral injury,Injury Severity Score(ISS),surgical approach,and fixation hardware.Results Among 112 male patients with unstable pelvic fractures,49(43.75%)developed ED after surgery.Multivariate logistic regression analysis indicated that urethral injury(OR=3.765,P=0.003)and pubic symphysis diastasis(OR=8.059,P=0.014)were independent correlated factors for ED after surgically treated unstable pelvic fractures in men.Conclusion Urethral injury and pubic symphysis diastasis are important factors for the development of ED after surgically treated unstable pelvic fractures in men.It is essential to collaborate with urologist in formulating a treatment plan for the early detection and intervention of ED.
关键词
勃起功能障碍/不稳定性骨盆骨折/关联因素分析/预后/创伤Key words
erectile dysfunction/unstable pelvic fracture/correlated factor analysis/prognosis/trauma引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据