阳痿的超声诊断分析

目的应用多普勒超声（DUS）技术观察阳痿（ED）患者阴茎血流情况，并进行诊断分型，为临床治疗提出指导性建议。方法对32例国际勃起功能评分（IIEF-5）为12．1-15．7（13．6±5．1）的ED患者，测定双侧海绵体动脉及阴茎背静脉内径、阴茎海绵体动脉收缩期最大血流速度（PSV）、舒张期最低血流速度（EDV）、阻力指数（RI）。阴茎海绵体内一次性注射（ICI）罂粟碱30mg＋酚妥拉明1mg 10min后，再次测定双侧海绵体动脉及阴茎背静脉内径、阴茎海绵体动脉PSV、EDV、RI、阴茎背静脉流速。应用SPSS12．0统计软件进行统计学分析。结果非血管性ED8例阴茎海绵体动脉PSV均≥35cm／s，RI≥1．0；阴茎背静脉常为间断低速静脉血流；15例为动脉性ED，阴茎海绵体动脉PSV均〈25cm/s，阴茎背静脉见间断低速静脉血流；6例为静脉性ED，阴茎海绵体动脉EDV均〉0cm／s，阴茎背静脉见持续静脉血流；3例为动静脉混合性ED，阴茎海绵体动脉PSV均〈25cm／s，阴茎背静脉见持续静脉血流。结论DUS检测阴茎海绵体动脉和阴茎背静脉血流并结合国际勃起功能评分（IIEF-5）是诊断阳痿疾病及其分型的有效方法。

Evaluation of penile hemodynamic status of patients with erectile dysfunction

Objective To evaluate the efficacy of Doppler ultrasound(DUS)in observing penile hemodynamic status of patients with erectile dysfunction(ED)and to give the advices for treatment.Methods 32 patients with erectile dysfunction were measured using the International Index of Erectile Function(IIEF),which erection function were 12.1-15.7(13.6 ±5.1).The inner diameters(Id),the peak systolic velocities(PSV),end diastolic velocity(EDV),resistance index(RI)of penile caverous arteries were measured in the flaccid phase.10 minutes after intra-cavernous injection of the combination of papaverine-phentolamine(30 mg/1 rag),The Id,PSV,EDV,RI of penile caverous arteries,the Id and velocity of dorsal penile vein were measured and recorded again.8 cases of non-vascular ED were taken as control group.All data analyzed by software of SPSS 12.0.Results All the PSVs in non-vascular ED were ≥35 cm/s,RI≥1.0,with intermittent slow dorsal venous flow.All the PSVs of 15 cases with arterial ED were less than 25 cm/s,with intermittent slow dorsal venous flow.All the EDVs in 6 cases of venous ED could be detected with consistent slow dorsal venous flow.All the PSVs of 3 cases with mixed ED were less than 25 cm/s,with consistent slow dorsal venous flow.Conclusion Combining the efficacy of Doppler ultrasound(DUS)with IIEF can diagnose and subtype ED.