初婚夫妇自然受孕力及影响因素的研究

８０年代末，上海市区７８２６对初婚夫妇的前瞻性随访显示，领证夫妇开始每周有性生活后１年时，９２％的未避孕者及９０％的曾避孕者已首次受孕。７６％的未避孕及８６％的曾避孕夫妇于３个月内即受孕。以领证为起点估计上海市区夫妇婚后１年的受孕力为８３％，而如以夫妇开始每周性生活为起点，则９２％的初婚夫妇于婚后１年时已受孕。比例风险模型显示，除夫妇婚龄及妻子毒物接触史等外，夫妇生育意愿、同胞数、排行、工作单位所     

上海市两社区初婚已分娩夫妇人工流产后开始选用避孕措施状态及影响因素的分析

对上海市两社区 71 0 1对于 1 987～ 1 988年初婚并于婚后 5～ 6年时已有孩子的夫妇进行 8年的前瞻性队列调查。结果显示 ,其中 9.3 % (6 6 3对 )的夫妇是于人工流产(人流 )术后开始选用避孕措施 (在本次调查的 2 52 7例产后至少有一次人流者中占2 6 .2 % )。在 6 3 3例产后完全暴露于妊娠危险状况的夫妇中 ,1 / 3的妻子因感避孕麻烦而原就准备于人流术后放环避孕。 51 .3 %的夫妇认为产后夫妇性生活少、哺乳期或未转经、月经量少不会受孕等而未于产后及时避孕。近 80 %未及时避孕的妻子于恢复性生活后 1年内受孕。56 .4 %未及时避孕的妻子均于人流术后放置环 ,其中 1 / 2的妻子认为于该时放环最有效。在产后非人流术后开始避孕的妻子中仅 8.1 %首选放环 ,从有效性出发首选放环的仅占 1 / 3。拟合双反应 L ogistic回归模型显示夫妇人口统计学 (妻子婚龄、宗教信仰、夫妇月收入 ) ,生育意愿 (婚后推迟生育时期 ) ,心理学因素 (产后妻子健康状况 ) ,妻子对人流的态度 ,夫妇的避孕知识 (特别丈夫在二访时 ) ,性生活状况等多种因素均显著影响到夫妇产后是否及时避孕。结果显示 :(1 )要加强对夫妇 ,特别是妻子 ,产后一旦恢复性生活及时避孕的教育 ;(2 )对有关人流后放环和人流术本身对妇女健康潜在危险性等开     

睾丸、阴茎大小与婚育关系的探讨(附868例报告)

本文报告在1988年做过睾丸、阴茎测量的868例婚前检查男子的婚后性生活和生育情况随访结果。其中婚后性生活不正常占0.58％;新婚夫妇一年内受孕率为89.81％;夫妇同居二年,未采用避孕措施而未曾受孕者50例,不育率为6.21％。简要讨论了睾丸体积,阴茎长度与被访者性生活和生育功能的关系。     

可孕妇女与不孕妇女自尊的调查分析

可孕指妇女或夫妇具有妊娠及抚育孩子的能力[1 ] ,在未避孕的情况下 ,6 0 %～ 70 %的夫妇在婚后6个月、80 %的夫妇婚后 9个月、90 %的夫妇婚后 1年就可以妊娠。不孕是指婚后未避孕、有正常性生活、同居 1年以上而未妊娠者 [2 ]。我国不孕妇女比例为 6 %～ 1 1 %。为了解我国可孕妇女和不孕妇女的自尊 ,1 997年 1 1月至 1 998年 2月 ,笔者对西安市 5所省市医院就诊的可孕、不孕妇女进行了抽样调查 ,旨在为从事妇女保健的临床护理人员、护理教育者以及护理科研工作者提供相关的理论依据。1　对象与方法1 .1　调查对象1 0 0例可孕、不孕妇女 ,…     

腹腔镜诊治女性不孕症120例分析

不孕症患者是婚后有正常性生活未避孕．同居2年未受孕者．世界卫生组织把不孕症临床标准定为1年。女方不孕症的发病原因比较复杂．早期、快速地查明病因，以便对症治疗．是提高不孕症治愈率的关键。腹腔镜作为一种微创性手术，具有创伤小、出血少、恢复快和粘连轻等优点，现已成为女性不孕症诊断和治疗的重要手段之一。现将本院120例不孕症进行腹腔镜检查治疗的情况总结如下。     

上海市婚后六年妻子避孕知识状况及影响因素分析

目的 :了解上海市 80年代末初婚 76 93对夫妇婚后 6年内妻子避孕知识状况。方法 :由描述及拟合多元线性回归模型对影响妻子婚后 6年时避孕知识得分的因素进行分析。结果 :该时 96 .3 %的夫妇已有一孩 ;妻子平均避孕知识得分 ( 1 6 .4分 )虽明显高于新婚 3个月时 ( 5.9分 ) ,但与婚后 1 5个月时比较 ( 1 1 .9分 ) ,无显著差异 ;0 .9%仍对避孕措施一无所知 ;2 0 .5%仍不会正确使用避孕套 ;虽 95%知道口服药 ,仅 3 1 .8%能正确述出使用方法 ,对安全期基本了解的正确性相对较高 ,在 91 .7%的知道该措施的妻子中 ,77.1 %能基本掌握推算排卵期方法。多元回归模型显示 ,该时妻子避孕知识得分主要与其对避孕措施的负性态度、了解生殖健康有关知识的广度或受丈夫的避孕知识的影响有明显关系。不了解避孕套能预防艾滋病、性病或不愿使用某避孕措施的妻子其避孕知识得分明显偏低 ;产后首选非宫内节育器或有多种性生活体位者该时的避孕知识得分也相对较高。结论 :随婚后时间的推移 ,上海市妻子避孕知识增长趋向缓慢。计划生育工作人员及社会媒体有必要结合生殖健康知识的普及 ,继续加强对已生育孩子的夫妇双方避孕知识 ,特别是口服药对妇女健康效应的教育 ,以提高可接受性 ,进一步保障妇女健康、降低人工流产率。     

上海市夫妇产后五年内首选避孕措施

对上海市卢湾、虹口两区80年代末7101对初婚并已生育孩子的夫妇进行产后避孕状况的定群队列随访研究.结果显示,产后5年内至少又妊娠过1次的夫妇为40.5%;妊娠过2或3次的夫妇分别为5.0%及0.8%;因带环或环移位而受孕的比例由1次妊娠的17.8%上升到3次妊娠的53.1%.首选避孕措施失败的主要原因安全期计算失误(33.4%)、环问题(其中带环妊娠17.8%、脱落12.6%)、未正确用套(17.8%)及体外排精失控(9.7%),因漏用措施而妊娠者多在避孕套使用者(65.2%).寿命表法分析显示,夫妇产后12个月时总避孕失败率(26.4%)略低于新婚期(44.0%),但产后首选口服药或杀精剂的同期失败率却明显高于新婚期首选该两类的夫妇,避孕套及体外排精使用者失败率产后低于新婚期.提示产后妻子避孕实践的认真性不及丈夫.为进一步降低放环后脱落或带环妊娠,对放环妇女必须加强指导及做好随访.     

男子不育症

育龄夫妇婚后同居，性生活正常而未避孕者，大多在1年内怀孕。若超过一定时间未孕称不孕。其时限国际妇产科联合会定为2年，美国不孕学会定为1年。不育症在临床上并不少见，国外资料为10％～15％。其中35％～40％不孕（育）症的原因在于男方。1病因男子不育是很多疾病或因素造成的结果。根据精子情况可分为绝对不育（无精症）和相对不育（少精症）；根据发病过程可分为原发性不育（双方婚后从未生育）和继发性不育（曾有生育）；按以生殖轴心和影响男子生育环节的病因，可分睾丸前性、睾丸性和睾丸后性（表1～3）。表1睾丸前性不育症表2睾丸…     

上海市夫妇产后五年内首选避孕措施失败及停用的研究

对上海市卢湾、虹口两区 80年代末 71 0 1对初婚并已生育孩子的夫妇进行产后避孕状况的定群队列随访研究。结果显示 ,产后 5年内至少又妊娠过 1次的夫妇为40 .5 % ;妊娠过 2或 3次的夫妇分别为 5 .0 %及 0 .8% ;因带环或环移位而受孕的比例由 1次妊娠的 1 7.8%上升到 3次妊娠的 5 3 .1 %。首选避孕措施失败的主要原因 :安全期计算失误 (3 3 .4% )、环问题 (其中带环妊娠 1 7.8%、脱落 1 2 .6% )、未正确用套 (1 7.8% )及体外排精失控 (9.7% ) ,因漏用措施而妊娠者多在避孕套使用者 (65 .2 % )。寿命表法分析显示 ,夫妇产后 1 2个月时总避孕失败率 (2 6.4% )略低于新婚期 (44 .0 % ) ,但产后首选口服药或杀精剂的同期失败率却明显高于新婚期首选该两类的夫妇 ,避孕套及体外排精使用者失败率产后低于新婚期。提示产后妻子避孕实践的认真性不及丈夫。为进一步降低放环后脱落或带环妊娠 ,对放环妇女必须加强指导及做好随访     

输卵管性不孕症诊疗进展

不孕症是指有婚后正常性生活、未采取避孕措施2年未受孕者。不孕症发病率呈逐年递增趋势,可能与晚婚晚育、人工流产、性传播疾病等相关,而输卵管性不孕是引起不孕的常见因素之一。近年大量文献报道输卵管性不孕症的各种诊断与治疗方法,本研究从输卵管性不孕症的特点、原因、诊断、治疗方面阐述输卵管性不孕症的研究进展,以提高对输卵管性不孕症的诊疗水平。     

Characteristics of male fertility after renal transplantation

We investigated factors such as time span between transplantation and having offspring, the dosage of immunosuppressive agents during fertilisation and the effects of fertilisation on recipient's renal allograft function in 212 male recipients registered at eight Chinese organ transplantation centres. Our results are as follows: the 212 male renal allograft recipients conceived with their wives between 15 and 204 months after transplantation. The wives who became pregnant at 15-24 months after the renal transplantation gave birth to a total of 20 babies with an average weight of 3115 ± 517 g, of which 3 (15.0%) were premature. The wives who became pregnant at 25-204 months after the renal transplantation gave birth to a total of 196 babies with an average weight of 3384 ± 438 g, of which 6 (3.1%) were premature. All recipients had normal renal function during the fertile period. In conclusion, the fertility capacity of male renal allograft recipients was associated with the time after transplantation and the dose of immunosuppressive agents used during fertilisation. It might be helpful to have a fertility capacity evaluation before fertilisation. There were no effects of fertility on renal allograft function.     

上海市男性性病患者性行为及避孕套使用情况分析

目的 :探讨男性性病患者的背景特征、性行为、避孕套的使用等情况 ,为性病防治工作提供依据。方法 :1 998年 5月 2 6日至 1 998年 1 2月 2 2日 ,以上海市最大的性病防治医院 2 2 66名男性性病患者 ( 1 5 1 7名在婚 ,664名未婚 ,85名丧偶或离异 )为对象 ,采用结构式问卷进行调查。调查内容包括对象的社会人口学待征、性行为、避孕套者使用等情况。结果 :男性患者的性行为具有高度的危险性 ,如多性伴和较少使用避孕套。在调查前的 1 2个月内 ,对象平均拥有 2个性伴 ,近 1 / 3的对象自报在过去 1 2个月中曾有过嫖娼行为。在控制了其它因素后 ,年长、居住在效区的对象更倾向于有嫖娼行为 ,下岗待业者以及未婚者较少有嫖娼行为。虽然 1 / 3多的对象使用过避孕套 ,但过去 1 2个月坚持使用避孕套者不到 1 %。在控制了其他因素后 ,年轻、性伴多者使用避孕套的比例较高 ;与小学及以下和高中文化程度相比 ,大专及以上文化程度者使用避孕套的比例较高 ,而初中文化程度者使用避孕套的比例较低。农民中使用过避孕套的比例较低 ,而行政管理人员使用过避孕套的比例较高。在控制了其他因素后 ,年轻、职业为商业和服务业职员或行政管理人员、离异或丧偶者以及调查前 1 2个月中性伴人数较多者在调查前 1 2个月使用过避孕套     

Co-occurrence of sexual dysfunction within young married couple dyads living in rural China: a population-based study

A total of 298 randomly selected married couple dyads in rural China were studied. Sexual dysfunction (SD) was reported by 84 (28.2%) of the husbands and 136 (45.6%) of the wives. Co-occurrence of SD was reported by 51 of the married couples; hence, SD co-occurred in the spouses of 60.7% of the husbands with SD and 37.5% of wives reporting SD. Pain during intercourse but not other SD of the wives was associated with SD of the husbands. Men's SD including inability to achieve orgasm, finding sex not pleasurable and lack of interest in sex, but not premature ejaculation or erectile dysfunction, were associated with the presence of SD among the wives. Decision-making control on sexual matters, communication between the spouses on sexual problems, the seeking of professional help, perceived adequacy of sexual knowledge as well as mental health and vitality quality of life indices were associated with co-occurrence of SD within the couple dyads.     

经阴道前壁手术对女性性功能的影响

目的 研究经阴道前壁手术对患者性生活的影响和随着术后时间延长性功能的变化趋势.方法 2001年1月至2007年1月在我院接受经阴道无张力尿道中段悬吊术(TVT)、经闭孔无张力吊带术(TVT-O)、前路植入网带及整体植入网带术的患者共142例,109例同意参加本研究.采用改良Lemack问卷评估术前3个月、术后6～12个月及术后12个月以后患者性生活质量.结果 109例患者中有48例是术前和(或)术后无性生活,余61例(56.0%)患者手术前后均有性生活.患者性生活的频率、对性生活的感觉、性高潮频率、性生活时是否感觉阴道存在吊带或网带及性伴不适症状术后与术前相比,差异均无统计学意义.根据患者对性功能的主观感受,21例(34.4%)自觉术后性功能下降,12例(19.7%)自觉改善,28例(45.9%)自觉无变化;术后12个月以后也无进一步改变.结论 61例患者中有40例患者(65.6%)术后性功能未受损,术后12个月以后与术后6～12个月相比,性功能未发生进一步变化.     

LIFE AFTER RADICAL PROSTATECTOMY: A LONGITUDINAL STUDY

PURPOSE: We investigate the longitudinal recovery of quality of life after radical prostatectomy in men with localized prostate cancer. MATERIALS AND METHODS: We assessed the self-reported health related quality of life in 247 men undergoing radical prostatectomy for prostate cancer. Patients were assessed at baseline before surgery and postoperatively every 3 months for 1 year and then every 6 months for up to 48 months (median 30). We measured general and prostate specific health related quality of life with the RAND 36-Item Health Survey 1.0 SF-36 and University of California, Los Angeles Prostate Cancer Index. The Cox proportional hazards regression model was used to determine whether some patients were more likely than others to have a successful return to baseline functioning after treatment. RESULTS: In the SF-36 60% of patients reached baseline in all domains by 3 months. By 12 months, greater than 90% of patients reached baseline in all domains. Mean recovery time for these domains was about 4(1/2) months. The recovery of urinary function to baseline was 21% at 3, 56% at 12 and 63% at 30 months, respectively. About 80% of patients recovered to baseline urinary bother. In the urinary domains patients who recovered did so at an average of 7 to 8 months, and there was little additional recovery after 18 months. By 1 year postoperatively, approximately a third of patients reached baseline sexual function and about half recovered to baseline sexual bother. At 2 years postoperatively, sexual function and bother returned to baseline in 40% and 60% of patients, respectively. Mean recovery time was about 11 months for sexual function and about 9 months for sexual bother. There was little additional recovery in the sexual domains after 18 to 24 months. In the bowel domains more than two thirds of patients returned to baseline by 3 months, and greater than 90% recovered by 12 months, with a mean recovery of 4.8 months. Unmarried men were more likely than those married to regain baseline sexual function (p = 0.03) and urinary function (p = 0.07). Patients who were 65 years and older were more likely than those younger to return to baseline sexual bother (p = 0.03). There were trends that showed patients with higher incomes as well as those who were white were more likely to recover baseline scores for urinary function and the physical component summary. Another trend suggested that men with a higher education were less likely to regain urinary function (p = 0.08). CONCLUSIONS: Most quality of life recovery occurs early after radical prostatectomy, except in several domains, including urinary and sexual, which continue to improve even beyond 2 years postoperatively. Patients should be encouraged that recovery may continue for months or years after surgery.     

性功能检测室在特殊类型插入障碍患者诊治中的作用

目的:为了明确性功能检测室在特殊类型插入障碍患者诊治中的作用。方法:2010年9月～2011年2月上海仁济医院男科门诊主诉为无法完成性生活的夫妇6对。均为婚后2～3个月内尝试性生活3～6次,因男方无法正常勃起而无法完成性交。女方不愿意继续尝试性生活,有离婚打算。使用上海市男科学研究所性功能检测室,对患者进行检测和性指导。该检测室有内外2间房间,分割墙上有半透镜一面,通过光线的变化,可由内间单向观察外间。检测时给予患者他达拉非20 mg口服诱导阴茎勃起后在外间进行血流多普勒超声检测。同时在内间女方可透过半透镜观察到男方的阴茎勃起,获得感官认识,此时指导医师再进行相关性指导以解除女方思想包袱。最后嘱患者尝试性生活。结果:6对夫妇均为女方性格急躁,男方内向。多普勒超声结果均提示阴茎血流正常。女方获得直观感受后,表示相信男方的勃起能力。随访1个月,所有夫妇均可正常进行性生活。结论:该类型的性功能检测室可使医师直接观察患者的勃起状况,通过给予女方直观感受,解除思想包袱,有利于进一步的性生活尝试,达到夫妻和睦的目的。     

Prevalence and correlates of sexual dysfunction among young adult married women in rural China: a population-based study

The study investigates prevalence of sexual dysfunction (SD), sexual satisfaction and their correlates in the rural female population in China. An anonymous cross-sectional study was carried out in a random sample of 1178 married of age 20-39 years in Dengfeng County, Henan, China. The prevalence of having at least one SD was 43 and 38% of the respondents were satisfied with their sexual life; 64.0% thought that sex was not important to them; and 85.7% believed that they do not have adequate sex-related knowledge. Having SD and high sexual satisfaction were associated with high mental health or vitality quality of life scores and better perceived health status. Other independent predictors of SD included sociodemographic variables, biological variables, life style factors and masturbation. It is concluded that SD was prevalent among the studied women and were associated with mental health. The sexual health among married women needs to be improved in rural China.