阴茎异常勃起的诊断与处理(附13例报告)

目的　提高阴茎异常勃起的诊治水平。　方法　阴茎异常勃起患者 13例 ,其中血管活性药物所致 9例 ,会阴外伤所致 1例 ,原因不明 3例。经体检、海绵体血气分析、阴茎彩色双功能超声等检查 ,分别行阿拉明海绵体注射及海绵体减压等治疗。　结果　 12例为低流量型异常勃起 ,1例为高流量型 ,经上述处理后 ,异常勃起均缓解。随访 3～ 4 3个月 ,勃起功能减退 4例 ,9例患者勃起功能无显著改变 ,无明显阴茎海绵体纤维化。　结论　海绵体血气分析和彩色双功能超声等检查有助于阴茎异常勃起准确及时的诊断。海绵体减压和阿拉明注射适用于多数患者 ,治疗时尽量避免对全身的影响。

Diagnosis and treatment of priapism

Objective To evaluate the diagnostic approaches and treatment choices for priapism,and to upgrade the diagnostic and therapeutic efficacy. Methods Thirteen patients with priapism were evaluated by physical examinations,cavernous blood gas analysis,color duplex ultrasonography and cavernosography.Among them 9 cases of priapism resulted from intracavernosal injection of vaso-active agents,1 from perineal trauma and 3 from unknown cause.All the 13 patients were treated with intracavernosal injection of aramine and cavernosal decompression. Results Among these cases of priapism,12 were of low-flow and 1 was of high-flow.After the treatment,all the patients with priapism achieved remission.During the follow-up of 3 to 43 months,4 cases experienced decreased erection;9 had no significant change of erection.No cavernous fibrosis of penis occurred in them. Conclusions Cavernous blood gas analysis and color duplex ultrasonography are helpful with the accurate and timely dignosis of priapism.Cavernosal decompression and intracavernosal injection of arimine can be applied to most of the patients,and in the course of the treatment systemic adverse events should be avoided.