阴茎异常勃起的鉴别诊断及急诊处理

目的:提高阴茎异常勃起的诊治水平。方法:对18例阴茎异常勃起患者的诊断和治疗进行了回顾性分析。结果:发病原因:白血病1例,海绵体注射罂粟碱16例,原因不明1例。发病至就诊时间4~18 h,平均7 h。均为低流量异常勃起。海绵体穿刺血液行血气分析3例,海绵体动脉血流彩色多普勒检查2例。17例经阴茎海绵体内注射缩血管药物、海绵体穿刺放血以及肝素化盐水冲洗后异常勃起消失。1例白血病诱发勃起的患者经上述治疗无效,后经化疗后恢复正常。结论:海绵体内注射罂粟碱诱发的阴茎异常勃起和白血病诱发的异常勃起均为低流量型异常勃起。阴茎海绵体内注射缩血管药物,海绵体穿刺放血冲洗可解除异常勃起。白血病诱发的异常勃起应强调原发病的治疗。

Differential diagnosis and emergency treatment of priapism

Objective:To elevate the level of differential diagnosis emergency treatment of priapism.Methods:A retrospective analysis was made for 18 cases of priapism.Results:There were 18 patients in this group,1 case of priapism was caused by leukemia,16 cases were caused by cavernosum injection of papaverine and 1 case was with unkown reason.The duration from onset to the admittance was from 4 hours to 18 hours.The average time was 7 hours,all were low flow type of priapisms.3 cases were haveing cavernous blood gas analysis and 2 patients were checked by color duplex ultrasonography.All 17 patients were treated with intracavernosal injection of aramine and cavernosal decompression and the priapism vanished after the treatment.One case with leukemia could not relief only after 1 to 3 days of chemical therapy.Conclusion:It is all low flow type of priapism caused both by cavernosum injection of papaverine and that of leukemia in this group.Intracavernosal injection of aramine and cavernosal decompression would be a effective ways to relief priapism.But the priapism caused by leukemia can only be relieved by chemical therapy.