彩色多普勒超声分度诊断对男性勃起功能障碍治疗的价值

目的 探讨彩色多普勒超声检查(CDFI)分度诊断对男性勃起功能障碍(ED)治疗的价值.方法 198例ED患者,行阴茎海绵体内血管活性物质注射(ICI)后,结合CDFI检测血流参数,根据其硬度分为Ⅱ～Ⅴ度组4个级别.根据不同的分度向患者推荐包括抗炎治疗、口服西地那非、内分泌治疗、真空负压吸引装置(VCD)、静脉瘘手术、阴茎假体植入、增强型体外反搏(EECP)在内的患者愿意接受的治疗方式.结果 198例ED患者,其注射前阴茎海绵体动脉血流峰值速度(peak systolic velocity,PSV),舒张末期速度(end diastolic velocity,EDV)、阻力指数(resistant index,RI)在四度组间差异无统计学意义(P＞0.05),而注射后阴茎海绵体动脉的PSV、EDV、RI在四度组别之间差异均有统计学意义(均P＜0.05),其中RI为每两组内差异均有统计学意义(均P＜0.05).按照ICI后阴茎海绵体动脉CDFI检测血流参数进行分度,选择合适的治疗措施,可提高ED患者的治疗满意率达91.91%(182/198).结论 ICI后CDFI测量阴茎海绵体动脉血流参数为依据,结合Schramck分度,向患者推荐其可接受的治疗方式,能显著提高ED治疗的临床满意率,是ED目标性诊断与治疗的一种合理模式.

Value of degree diagnosis with color Doppler flow imaging in the treatment of male erectile dysfunction

Objective To study the value of degee diagnosis with color Doppler flow imaging (CDFI) in the treatment of male erectile dysfunction (ED).Methods After CDFI and jntracavcmosa vasoactive agent injection (ICI) with papverine 60 mg and pmstaglandin E1 10 μg,198 male ED patients were divided into 4 groups by their penile stifiness based on the Schramek criterion.The thempeutic methods such as antibiotics for prostatitis,sexual behavior therapy,sildenafil,vacuum constriction device (VCD),vcna fistula repairing operation,prosthetic implantation and enhanced external counterpulsation (EECP) were recommended to the patients according to their difierent penile stiffness degree and their different preferences.Results Prior to ICI,there was no significant difference in the cavemosa artery peak systolic velocities (PSV).end diastolic velocities (EDV),resistant indexes (RI),dorsal artery PSV,EDV,Riand deep dorsal vein velocity(V)(P＞0.05).After ICI,the cavernosa artery PSV,EDV and RI were significantly difierent (P＜0.05) while other indices were not(P＞0.05).The patients were treated differently according to their preferences.The selective goal-oriented therapy increased the satisfactory rate to 91.91% (182/198).Conclusion Based on the penile stiffness degree with CDFI plus ICI,different therapeutic methods yield a better clinical outcome.