动态检测阴茎动脉血流剪应力的研究

目的探讨动态检测阴茎海绵体动脉血流剪应力的方法及意义。方法利用手握式真空负压吸引器对阴茎进行间断抽吸,彩色多普勒超声探测12例心理性勃起功能障碍患者会阴部阴茎海绵体动脉直径、血流速度、血流阻力指数等,根据公式:τm=η×4×Vm/Dr,计算阴茎勃起各阶段的动脉血流剪应力。结果负压吸引前,阴茎在自然状态下左右两侧的海绵体动脉血流剪应力(单位dynes/cm2)平均13.40±4.58;负压吸引后达到Ⅱ度勃起状态时剪应力平均为15.64±4.62;负压后达到Ⅳ度勃起状态时剪应力平均为15.66±4.03。阴茎Ⅱ级勃起状态和Ⅳ级勃起状态平均剪应力较自然状态高,具有统计学意义(P=0.032、P=0.047)。Ⅳ级勃起状态平均剪应力与Ⅱ级勃起状态相比,无统计学差异(P=0.985)。结论彩色多普勒超声结合真空负压吸引器可动态检测阴茎海绵体动脉血流剪应力;揭示真空负压吸引增加阴茎动脉血流量现象。

A study of detecting penile arterial fluid shear stress dynamically

Objective To investigate the methods and significance of detecting penile cavernous arterial fluid shear stress dynamically. Methods Use hand-grasp vacuum constriction device to suck penis dis-continuously, and use color Doppler ultrasound to detect cavernous arterial diameter,blood flow speed and resistance index on the perineum of 12 patients with psychogenic erectile dysfunction. Then calculate the shear stress by the formula:τm=η×4×Vm/Dr. Results The mean fluid shear stress (Unit:dynes/cm2)of bilateral penile cavernous artery was 13.40±4.58 in the natural state without vacuum suction. The mean fluid shear stress were 15.64±4.62 and 15.66±4.03 respectively when the erection achieve Ⅱ and Ⅳ degree state with vacuum constriction device. They were both higher than the stress in the natural state (P=0.032,P=0.047). There was no significant difference (P=0.985)between Ⅱ and Ⅳ degree erectile state. Conclusion Color Doppler ultrasound combined with vacuum constriction device could detect penile cavernous arterial fluid shear stress dynamically, and it could reveal the phenomena that vacuum constriction device could increase blood flow volume of penile artery.