缺血型阴茎异常勃起的处理与预后(附14例报告)  

Practical management and prognosis of ischemic priapism(Report of 14 cases)

作　　者：杜跃军[1] 谭万龙[1] 毛向明[1] 郑少斌[1] 吴芃[1] 张辉见[1] 陈鹏亮[1] 熊林[2] 

机构地区：[1]南方医科大学南方医院泌尿外科,广州510515 [2]解放军第187中心医院外一科

出　　处：《临床泌尿外科杂志》2008年第6期415-417,420,共4页Journal of Clinical Urology

摘　　要：目的：探讨缺血型阴茎异常勃起的临床特点。方法：回顾性分析14例缺血型阴茎异常勃起患者的临床资料，持续勃起时间6-168h。平均32h。非手术治疗5例。手术治疗9例。结果：术后阴茎完全恢复疲软时间0-9天，平均3．5天。11例随访3-38个月，7例于术后7天-5个月恢复正常勃起功能，其中3例持续勃起时间≤12h。3例为13-24h。1例为48h；4例术后仍出现勃起功能障碍，其中1例持续勃起时间为12-24h，2例为24-48h。1例〉48h。3例失访。结论：持续缺氧及酸中毒是导致缺血型阴茎异常勃起预后不良的主要原因。对于勃起时间≤24h患者，采取有效手段解除病理性勃起，可以有效避免继发不可逆转的阴茎勃起障碍；对于勃起时间〉24h患者，为避免进一步延误治疗时机，可直接选择手术治疗。Objective： To investigate the practical management and prognosis of ischemic priapism. Methods： The data from practical management and follow-up of 14 patients with ischemic priapism in our institution, from Feb. 1992 to Apr. 2006, were retrospectively analyzed. Results：The mean age of 14 cases was 31. 5 years old , ranged from 18 to 71 years old. Resolutions occurred in 5 cases with non-surgical treatment and 9 cases with surgi cal treatment. The time to achieve sufficient detumescence was ranged from 0-9 days, mean for 3.5 days. After follow-up 11 cases of 3 to 38 months（mean for 18.5 months）, normal erection was observed in 7 of 11 cases, 3 with priapismwithin 12 hours,3 for 12-24 hand 1 for 24-48h. EDoccuredin4 cases,1 with priapism for 12-24 h,2 for 24-48h and 1 over 48 h. Conclusions：Sustained conditions of hypoxia and acidosis is the main cause of the poor prognosis of ischemic priapism. Proper interventions within 24 h could prevent irreversible erectile dysfunction efficaciously. For patients with priapism over 24 h,surgical treatment could be applied directly in fearing losing the last crucial point to preserve the erectile function.

关 键 词：阴茎异常勃起 缺血 治疗 预后 

分 类 号：R697[医药卫生—泌尿科学]