双侧阴茎海绵体注射肾上腺素对泌尿外科内镜手术中阴茎持续勃起的疗效  

Effect of bilateral intracavernous injection of epinephrine for persistent penile erection in urological endoscopic surgeries under general anesthesia

作　　者：石亚平 王薇 陈春婷 王玥 刘毅 周懿 Shi Yaping;Wang Wei;Chen Chunting;Wang Yue;Liu Yi;Zhou Yi(Department of Anesthesiology,Changhai Hospital Affiliated to Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学长海医院麻醉科,上海200433

出　　处：《国际泌尿系统杂志》2022年第6期1068-1072,共5页International Journal of Urology and Nephrology

基　　金：上海市科学技术委员会项目(19411967500)。

摘　　要：目的评价双侧阴茎海绵体注射小剂量低浓度肾上腺素治疗全身麻醉下泌尿外科内镜术中阴茎持续勃起的有效性和安全性。方法选取2017年7月至2020年12月海军军医大学长海医院全身麻醉下行内镜手术的男性患者1628例,采用双侧阴茎海绵体注射小剂量低浓度肾上腺素3μg(1μg/mL)治疗。5 mL注射器抽取肾上腺素接1 mL针头于双侧阴茎海绵体进针,回抽无血每侧给予肾上腺素1.5μg。记录起效时间及血流动力学变化,注射肾上腺素前(T0)以及注射肾上腺素即刻(T1)、1 min(T2)、2 min(T3)、3 min(T4)时患者的平均动脉压(MAP)、心率(HR)。术后随访24 h,远期随访1个月,记录相关不良事件。结果所有患者的内镜手术中阴茎持续勃起发生率为3.87%(63/1628),本方案治疗有效率为100%,起效时间为(43±10)s,注射前后生命体征平稳,未使用任何血管活性药物,MAP上升1%,HR上升2.1%。注射肾上腺素后,与T0时比较,T1、T2、T3、T4时的MAP、HR均出现不同幅度的升高,差异均无统计学意义(均P>0.05)。术后24 h及1个月随访,患者未出现明显不良反应。结论双侧阴茎海绵体注射小剂量低浓度肾上腺素(1μg/mL,3μg)能快速安全地治疗泌尿外科内镜手术期间的阴茎持续勃起。Objective To evaluate the efficacy and safety of bilateral intracavernous injection of low-dose and low-concentration epinephrine in the treatment of persistent penile erection in urological endoscopic surgeries under general anesthesia.Methods From July 2017 to December 2020,1628 male patients who underwent urological endoscopic surgeries under general anesthesia in the Changhai hospital affiliated to naval medical university were selected.Sixty-three patients with persistent penile erection were treated by bilateral injection of 3μg(1μg/mL)of epinephrine into the cavernous body of the penis.Epinephrine was drawn with a 5 mL syringe and a 1 mL needle was inserted into the cavernosum of the penis on both sides,and 1.5μg of epinephrine was administered on each side without blood.The onset time and hemodynamic changes were recorded.Mean arterial pressure(MAP)and heart rate(HR)were measured before epinephrine injection(TO)and immediately after epinephrine injection(T1),1 min(T2),2 min(T3),and 3 min(T4).The patients were followed up for 24 h and 1 month after operation,and the related adverse events were recorded.Results The incidence of continuous penile erection during endoscopic surgery was 3.87%(63/1628).The effective rate of this protocol was 100%,the onset time was(43±10)s,the vital signs were stable before and after injection,no vasoactive drugs were used,the mean arterial pressure increased by 1%,and the heart rate increased by 2.1%.After injection of epinephrine,MAP and HR at T1,T2,T3 and T4 all increased in different amplitude compared with TO,but the differences were not statistically significant(all P>0.05).At 24 h and 1 month follow-up,there was no obvious adverse reaction.Conclusions Bilateral intracavernous injection of low-dose and low-concentration epinephrine(1μg/mL,3μg)can quickly and safely solve persistent penile erection during urological endoscopic surgeries under general anesthesia.

关 键 词：肾上腺素 阴茎海绵体注射 内窥镜检查 阴茎勃起 

分 类 号：R699.8[医药卫生—泌尿科学]