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目的系统评价减重手术对男性勃起功能的影响。方法计算机检索Pub Med、EMbase、The Cochrane Library(2016年5期)、CNKI、CBM、VIP和Wan Fang Data数据库,搜集男性肥胖患者减重手术与性功能关系的随机对照试验(RCT)和自身前后对照试验,检索时限从建库至2016年5月。由2位研究者独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用Rev Man 5.3软件进行Meta分析。结果共纳入7个研究,共计270例患者,Meta分析结果显示,行减重手术后患者勃起功能有明显改善[MD=5.05,95%CI(3.52,6.59),P<0.000 01],性欲明显提高[MD=0.99,95%CI(0.47,1.51),P=0.000 2],同时性接触满意度与性功能总体满意度与术前相比均有明显提高,但性高潮功能手术前后并无明显差异[MD=–0.21,95%CI(–0.74,0.33),P=0.45]。结论减重手术能明显改善重度肥胖患者的勃起功能、提高性欲和性生活满意度。受纳入研究数量和质量的限制,上述结论尚需开展大样本、高质量的临床研究进行验证。
Objective To systematically evaluate the effect of weight loss surgery on male erectile function. Methods A randomized controlled trial (RCT) was conducted to investigate the relationship between weight-reducing surgery and sexual function in male obesity patients by searching PubMed, EMbase, The Cochrane Library (2016 Issue 5), CNKI, CBM, VIP and Wan Fang Data. Control trial, search time limit from building to May 2016. Two researchers independently screened the literature, extracted data, and assessed the methodological quality of the included studies. Meta-analysis was performed using Rev Man 5.3 software. RESULTS: A total of 270 studies were included in 7 studies. Meta-analysis showed significant improvement in erectile function after MDR (MD = 5.05, 95% CI 3.52, 6.59, P <0.000 01) (MD = 0.99,95% CI (0.47,1.51), P = 0.0002]. Meanwhile, the satisfaction of sexual contact satisfaction and sexual satisfaction were significantly improved compared with those before operation, but no significant difference was found between before and after orgasmic surgery Significant differences [MD = -0.21, 95% CI (-0.74, 0.33), P = 0.45]. Conclusion Weight loss surgery can significantly improve erectile function in patients with severe obesity and improve sexual desire and sexual satisfaction. Due to the limited number and quality of studies involved, the above conclusion still needs to be verified by large sample and high quality clinical research.