阳痿的系统诊断与阶梯治疗

目的：探讨阳痿的诊断与治疗方法。方法：对200例阳痿病人进行系统诊断与阶梯治疗。其系统诊断法为经病史、查体、实验室检查、常规进行罂粟碱试验，可分别进行内分泌测定、PBI测定、超声多普勒血流图测定、灌注性海绵体造影、球海绵体反射潜伏时间测定等。治疗选择阶梯疗法：第一阶梯采取性感集中训练法，药物疗法，盆底括约肌锻炼法;第二阶梯进一步合用VCD疗法.化学假休疗法;第三阶梯采用手术治疗，包括背深静脉动脉化、静脉性手术、半硬性假体植入术。结果：分别诊断为心理性阳痿85例。占42.5％;动脉性阳痿31例，占15.5％;静脉性阳痿48例.占24％;神经性阳痿15例，占7.5％;内分泌性阳痿6例.占3％;糖尿病性阳痿8例，占4％;药物性阳痿7例，占3.5％。经阶梯疗法共治愈28例，占14％;显效46例，23％;有效69例，占34.5％、总有效率为71.5％、结论：系统诊断法与阶梯治疗阴茎勃起障碍是非常有效的诊治方法。

The systematic diagnosis and ladder''''s treatment of impotence

Objectives: In order to sutdy the diagnosis and treatment of impotence.Methods: We use sistematic diagnosis to sdudy 200 patients with erectile dysfuction on the basis of medical history , physical examination, laboratory evaluation, papaverine 's test endocrine hormones check,penile brachial index (PBI), penile doppler ultrasonography,pouring into cavernososgraphy,incubation period of bulbospongiosus's reflex (not all tests were conducted in each man). Ladder's treatment was applied in the cases. First step ,sex training exersise,Oral medications,pelvic floor exersise were used. Second step,vacuum pumps or intracavernosal injections of vasoactive drugs was applied. Third step,vacuum pumps or intracavernosal injections of vasoactive drugs was applied. Third step,vascular surgery or implantation of a penile prothesis were used. Results: 85/200(42. 5 percent ) were psychological ED; 31 / 200 (15. 5 percent ), arterial; 48/200 (24 percent ), venous; 15/200 (7. 5 percent ), nervous; 8/ 200 (4 percent ), diabetic; 7/200 (3. 5 percent ) , of drugs. In the cases, 28/200 (14 percent ) patients with ED were curedwith ladder ' s treatment; 46/200 (23 percent ), marked effective;69/200(34. 5 percent), effective. The total effective rate was 71. 5 percent. Conclusion: Systematic diagnosis and ladder's treatment is very useful and effective method for patients with impotence.