摘要： 目的·了解在三甲医院就诊的男性肿瘤患者对生育力保存的认知情况。方法·采用问卷调查的方法，设计“男性肿瘤患者对生育力保存认知调查问卷”，于2018年1月1日—12月31日，对在上海交通大学医学院附属仁济医院就诊的50岁及以下的男性肿瘤患者进行电话随访和当面随访，并进行问卷填写。结果·本次调查男性患者共计212例，平均年龄（34.4±0.5）岁；其中61例（28.8%）未生育子女，27例（12.7%）了解生育力保存，28例（13.2%）有意愿做生育力保存，87例（41.0%）知道放射治疗（放疗）或化学治疗（化疗）可能会影响生育能力。在了解生育力保存的27例患者中，19例（70.4%）通过医师途径得知，5例（18.5%）通过媒体途径得知，6例（22.2%）通过网络途径得知。有生育史的男性患者更倾向于无生育诉求（
P=0.000）。年龄低于25岁的男性患者更愿意生育（
P=0.046）。本科及以上学历（
P=0.006）、有生育力保存意愿（
P=0.010）的患者更倾向于了解生育力保存。有无接受过化疗（
P=0.013）、是否有子女（
P=0.044）是影响患者有意愿做生育力保存的主要因素。结论·目前大多数男性肿瘤患者缺乏对生育力保存的认知，可能与患者文化水平低和医务工作者宣教工作不足有关。医务工作者需要加大生育力保存的宣教力度，避免有生育意愿的患者失去繁衍后代的机会。
关键词: 生育力保存, 男性, 肿瘤, 问卷调查 Abstract: Objective·To analyze the perception of fertility preservation of the male patients with malignant tumors consulted in Grade-A tertiary hospitals in China through questionnaires.
Methods·From January 1st, 2018 to December 31, 2018, responses from the male cancer patients (≤50 years old) who had been treated in Renji Hospital, Shanghai Jiao Tong University School of Medicine were collected through a questionnaire survey.
Result·There were 212 male patients diagnosed with malignant tumor with a median age of (34.4±0.5) years in the current study. Among them, 61 (28.8%) were childless, 27 (12.7%) had a brief comprehension of fertility preservation, 28 (13.2%) intended to do fertility preservation, and 87 (41.0%) were aware that chemotherapy and radiotherapy might affect their fertility. Moreover, 27 patients who approximately understand fertility preservation got this knowledge from various ways. Nineteen of them (70.4%) were informed from doctors, 5 (18.5%) from media and 6 (22.2%) from internet. Male patients who have kids tended to refuse fertility preservation (P=0.000). Patients younger than 25 years old in the group were more likely to have children (P=0.046). Those with bachelor degree or above (P=0.006), and those with the desire to preserve fertility (P=0.010) were more likely to understand fertility preservation. Therefore, receiving chemo-radiotherapy (P=0.013) or not as well as having children (P=0.044) or not were two main reasons influencing patients' willingness to choose fertility preservation.
Conclusion·At present, the majority of male patients with cancer lack of the knowledge of fertility preservation, which may be due to the low literacy level of patients and inadequate publicity of medical workers. Consequently, medical staffs need to enhance the propaganda of fertility preservation, in case that patients with fertility intention lose the chance of reproduction .
Key words: fertility preservation, male, cancer, questionnaire PDF全文下载地址:
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