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目的:研究彩色多普勒超声(CDDS)在血管性勃起功能障碍(ED)中的诊断价值,从而为患者临床诊断方式的选择提供参考。方法:选择本院内2012年4月至2015年3月期间因ED入院接受治疗的男性患者248例,在患者接受检查前,需将酚妥拉明、罂粟碱以及前列腺素-E1等药物混合液0.2 m L注入阴茎海绵体内,使得诱导阴茎勃起,随后使用彩色多普勒超声系统进行诊断,对阴茎海绵体动脉的收缩期最大血流率(PSV)、舒张末期血流率(EDV)、阻力指数(RI)等指标进行记录,对各指标诊断ED的应用价值进行评估。结果:在248例患者中,存在血流动力学异常病例172例,其中96例患者为动脉性ED,72例患者为静脉性ED;72例血流动力学正常病例,为非血管性ED。合并糖尿病25例,占10.08%;高血压17例,占6.85%;高血脂116例,占46.77%;阴茎硬结症7例,占2.82%;阴茎海绵体纤维化8例,占3.23;经腹前列腺切除术后者9例,占3.2%,经尿道切除前列腺术后者8例,占3.23;吸烟者196例,占79.03%。血管性ED患者的FPSV、PSV、EDV明显低于非血管性ED患者的,差异均有统计学意义(P<0.05);且在血管性ED患者中,动脉性FPSV、ED、EDV患者的PSV明显低于非血管性ED患者的,差异均有统计学意义(P<0.05)。在指标对比中,血管性ED患者的RI与非血管性ED患者的RI无明显差异(P>0.05),但静脉性ED患者的RI明显低于非血管性ED患者的,差异均有统计学意义(P<0.05)。在96例动脉性ED患者中,行选择性阴部内动脉造影术有11例,动脉性病变8例,彩色超声多普勒检查与选择性阴部内动脉造影术符合率为72.73%。结论:在诱导阴茎勃起后,对患者进行彩色多普勒超声系统诊断,能够有效排除阴茎在疲软状态下存在的可变性因素,能够准确反映阴茎血流动力学状态,从而能够准确筛查血管性ED疾病,其检测结果的准确性优于动脉造影,临床应用价值较高,值得进一步推广使用。
Objective: To study the diagnostic value of color Doppler ultrasonography (CDDS) in vascular erectile dysfunction (ED), and to provide a reference for the choice of clinical diagnosis. Methods: A total of 248 male patients admitted to our hospital from April 2012 to March 2015 were enrolled in this study. Before the patients were examined, the mixture of phentolamine, papaverine and prostaglandin-E1 and other drugs 0.2 m L injected into the penile cavernous so that penile erection was induced, followed by a color Doppler ultrasound system for the diagnosis of penile cavernosal systolic maximum flow rate (PSV), end-diastolic flow rate (EDV), resistance Index (RI) and other indicators were recorded, the diagnostic value of each index ED value assessment. RESULTS: Of the 248 patients, 172 had hemodynamic abnormalities, of which 96 were arterial ED and 72 were venous ED; 72 were hemodynamically normal and non-vascular ED. 25 cases of diabetes mellitus, accounting for 10.08%; 17 cases of hypertension, accounting for 6.85%; 116 cases of hyperlipidemia, accounting for 46.77%; penile sclerosis in 7 cases, accounting for 2.82%; penile cavernous fibrosis in 8 cases, accounting for 3.23; Among the 9 cases (3.2%) who underwent prostatectomy, 8 cases (3.23%) underwent transurethral resection of the prostate, and 196 (79.03%) smokers. The levels of FPSV, PSV and EDV in patients with vascular ED were significantly lower than those with non-vascular ED (P <0.05). In patients with vascular ED, the mean arterial FPSV, ED, EDV in patients with PSV Significantly lower than non-vascular ED patients, the difference was statistically significant (P <0.05). In the index comparison, there was no significant difference between RI and non-vascular ED in patients with vascular ED (P> 0.05), but the RI in patients with intravenous ED was significantly lower than that in non-vascular ED Significance (P <0.05). In 96 patients with arterial ED, there were 11 cases of ICA and 8 cases of arterial disease. The coincidence rate of color Doppler ultrasound and selective intra-arteria intra-arterial angiography was 72.73%. Conclusion: After the erection of the penis, the diagnosis of color Doppler ultrasound system can effectively exclude the variability of the penis in the weak state, accurately reflect the penile hemodynamics, and thus can accurately detect the vascular ED disease, the accuracy of its detection results better than arteriography, clinical application of higher value, it is worth further promotion and use.