阴茎尿道海绵体分流和隧道术治疗低流量型阴茎异常勃起超48h患者的经验  

Experiences of penileurethral cavernous shunt and tunneling in the treatment of patients with low-flow priapism longer than 48 hours

作　　者：杨晓健 张浩[2] 陈桂丽[2] 罗丽 黄慧虹 杨帅 邱润清 钟美浓 Yang Xiaojian;Zhang Hao;Chen Guili;Luo Li;Huang Huihong;Yang Shuai;Qiu Runqing;Zhong Meinong(Department of Andrology,Reproductive Center,Dongguan Maternity and Child Health Care Hospital,Guangdong 523000,China;Department of Urology,Department of Urology,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)

机构地区：[1]东莞市妇幼保健院生殖中心男科,广东523000 [2]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2022年第5期442-446,共5页Chinese Journal of Endourology(Electronic Edition)

基　　金：广东省基础与应用基础研究基金(2019A1515010975);中山大学护理青年人才培育基金(N2020Y03)。

摘　　要：目的探讨阴茎尿道海绵体分流+隧道术治疗超48h的低流量型阴茎异常勃起的临床治疗和术后护理经验。方法5例低流量型阴茎异常勃起超48h的患者,排除手术禁忌证后行阴茎尿道海绵体分流+隧道术,术后医护密切配合,通过抗凝、抗雄激素以及基于赋能教育理论的Milk技术——鼓励患者与家属参与疾病管理,采用Milk技术促进阴茎血液循环,定时评估阴茎勃起硬度,进行围手术期护理,尽量恢复阴茎海绵体动脉血流。结果手术均顺利完成,5例患者治疗后阴茎均能逐渐疲软,疼痛缓解,住院3d内均顺利出院,出院后1个月内异常勃起均消除,术后随访6~12个月,1例患者能维持3级勃起硬度,能完成性交,1例患者能维持2级勃起硬度,3例患者仅能维持1级勃起硬度,均不能完成性交。结论阴茎尿道海绵体分流+隧道术治疗超48h的低流量型阴茎异常勃起是安全有效的,Milk技术为促进阴茎术后血液循环恢复提供了一种新的途径,值得临床进一步推广,鉴于此5例阴茎异常勃起患者异常勃起病程长,性功能恢复比例不高,性功能恢复治疗有待进一步研究。Objective To explore the clinical treatment and postoperative nursing experiences of penile urethral cavernous shunt and tunneling for low-flow priapism greater than 48 hours.Methods Five patients with low-flow priapism longer than 48 hours underwent penile urethral cavernous shunt and tunneling after surgical contraindications were excluded.Postoperative medical care was closely coordinated through anticoagulation,antiandrogen and based on the theory of empowerment education Milk technology-encourage patients and their families to participate in disease management,using Milk technology to promote penile blood circulation,regularly assess the erection hardness of the penis,perform perioperative care,and try to restore penile cavernous arterial blood flow.ResultsThe operations were successfully completed.After treatment,the penis of the 5 patients was gradually weakened and the pain was relieved.They were discharged smoothly within 3 days of hospitalization,and all the abnormal erections were eliminated within 1 month after discharge.Follow-up for 6 to 12 months,1 case was able to maintain Grade 3 erectile hardness and could complete sexual intercourse.One patient maintained Grade 2 erectile hardness.Three patients could only maintain Grade 1 erectile hardness and could not complete sexual intercourse.Conclusion Penile urethral cavernous shunt and tunneling is safe and effective to treat low-flow priapism longer than 48 hours.Milk technology provides a new way to promote the recovery of blood circulation after penile surgery,which is worthy of further clinical promotion.These 5 patients with priapism have a long course of priapism,and the proportion of sexual function recovery is not high.The treatment of sexual function recovery needs further study.

关 键 词：低流量型 阴茎异常勃起 Milk技术 围手术期护理 赋能教育 

分 类 号：R699.8[医药卫生—泌尿科学]