阴茎异常勃起的诊断及治疗（附13例报告）

目的：探讨阴茎异常勃起的病因、诊断、分型及治疗.方法：阴茎异常勃起患者13例,年龄20～61岁,平均36岁.勃起时间16～240 h.平均128 h.根据阴茎海绵体血气分析,阴茎海绵体超声多谱勒检查,放射性核素显像,选择性阴部内动脉造影等检查对患者进行诊断和分型.根据分型及病情轻重分别给以保守治疗、选择性阴部内动脉栓塞术、阴茎海绵体灌洗术等治疗.结果：5例高流量型阴茎异常勃起患者均有外伤史,8例低流量型阴茎异常勃起病因较为复杂.所有患者经相应治疗后阴茎勃起消失.随访2～24个月,5例高流量型患者均保留良好的勃起功能,7例低流量型患者有不同程度的勃起功能减退.结论：详细的病史、阴茎海绵体血气分析、彩色多谱勒超声检查、阴部内动脉造影是区分高流量型和低流量型阴茎异常勃起的重要方法.高流量型阴茎异常勃起可采取保守治疗和选择性阴部内动脉栓塞术治疗.而阴茎海绵体灌洗术是治疗低流量型阴茎异常勃起的较好选择.

Diagnosis and Treatment of Priapism(Report of 13 Cases)

Objective：To evaluate the cause, diagnostic approaches and treatment choices of priapism. Methods：Thirteen patients whose mean age was 36 years （range 20-61 years） with priapism were evaluated . The pri apism lasted 16 to 240 h with a mean of 128 h. All 13 patients were evaluated by cavernous blood gas analysis and color duplex ultrasonography. 2 patients were evaluated by arteriography, 2 patients were evaluated by radlonu clide image. Patients were treated by conservative treatment, arterial emboliazation and cavernous clysis based on the diagnosis. Results：All 5 cases who resulted from external injury of perineal position or radix penis were high- flow priapism. 8 cases were low flow priapism. After the treatment, all the patients with priapism achieved remis- sion. During the follow up of 2 to 24 months, 5 cases of high-flow priapism had no significant change of erection and no cavernous fibrosis of penis occurred in them. 7 cases of low-flow priapism experienced decreased erection. 1 case was lost. Conclusions：Cavernous blood gas analysis, color duplex ultrasonography, arteriography and radio nuclide image are helpful to the dignosis and typing of priapism. High-flow priapisrn can treated by conservative treatment and arterial emboliazation. Cavernous elysis is the better choice for the low-flow priapism.