动态超声观察血管性勃起功能障碍患者阴茎血流动力学的应用

目的:探究动态超声在观察血管性勃起功能障碍(ED)患者阴茎血流动力学上的临床应用效果。方法:将我院2013年1月至2016年1月接治的220例疑似血管性ED患者纳入研究,并选取100例心理性ED患者进行对照。应用阴茎海绵体注射血管活性药物试验(ICI)及多普勒超声对所有入选患者的阴茎海绵体进行血流动力学检测,分析不同类型ED患者在ICI前后阴茎长度、周长的变化以及收缩期峰值流速、舒张末期峰值流速、血流阻力指数的变化。结果:在220例疑似血管性ED患者中,动脉性ED患者74例,静脉性ED患者65例,混合血管性ED患者81例。动脉性ED、混合血管性ED患者的阴茎海绵体内径、PSV和EDV上均小于静脉性ED和心理性ED患者,而动脉性ED和心理性ED在RI上明显高于静脉性ED和混合血管性ED,差异具有统计学意义(P0.05)。ICI试验之前,动脉性ED、静脉性ED、混合血管性ED、心理性ED四组患者在阴茎周长、长度上比较并无显著性差异(P0.05);ICI试验后,动脉性ED患者的阴茎周长、阴茎长度明显短于静脉性ED、混合血管性ED、心理性ED患者,差异具有统计学意义(P0.05)。结论:彩色多普勒超声能够极为清晰地反映出血管性ED患者的阴茎血流动力学状态,为准确有效地判断血管性ED分型提供有力的诊断依据,在临床鉴别上值得推广使用。

Application of dynamic ultrasound in observing the penile hemodynamics of patients with vascular erectile dysfunction

Objectives:To research the clinical application of dynamic ultrasound to observe the penile hemodynamics of patients with vascular erectile dysfunction (ED).Methods:220 patients with suspected vascular ED in our hospital from January 2013 to January 2016 were selected as the research objects.At the same time,100 heart rational ED patients were selected as the control group.Hemodynamic examination for the penis of all patients was conducted by intracavernous injection of vasoactive drugs test (ICI) and doppler ultrasound.The changes in penile length,circumference and the peak systolic velocity,the end diastolic peak velocity and blood flow resistance index in patients with different types of ED before and after ICI were analyzed.Results:In the 220 patients with suspected vascular ED patients,there were 74 patients with arterial ED,65 venous ED patients,and 81 patients with mixed vascular ED.The penile diameter,PSV and EDV of arterial ED and mixed vascular ED patients were smaller than these of venous ED and psychological ED patients,while the RI of arterial ED and psychological ED patients was significantly higher than that of venous ED and mixed vascular ED patients,both with statistically significant difference (P ＜ 0.05).Before ICI test,there were no significant differences in penile girth and length among arterial ED patients,venous ED patients,mixed vascular ED patients and psychological ED patients (P ＞0.05).After ICI test,the penile girth and penis length of arterial ED patients was significantly shorter than that of venous ED,mixed vascular ED,psychological ED patients,with statistically significant difference (P ＜ 0.05).Conclusion:Color Doppler ultrasound can very clearly reflect the penile hemodynamic status of vasculogenic ED patients,which provides strong evidence for the diagnosis of vasculogenic ED types,thusly worthy to be popularized in clinical.