彩色多普勒超声在阴茎折断中的应用价值  

Application value of color Doppler ultrasonography in the diagnosis of ruptured tunica albuginea of the corpus cavernosum penis

作　　者：唐渊[1] 康建敏 彭靖[1] 袁亦铭[1] 张志超[1] 韩迪[1] 孟雨佳 梅满金 TANG Yuan;KANG Jian-min;PENG Jing;YUAN Yi-ming;ZHANG Zhi-chao;HAN Di;MENG Yu-jia;MEI Man-jin(Center of Andrology,Peking University First Hospital,Bejing 100034,China;Department of Urology,People Hospital of Xiangtan County,Xiangtan,Hunan 411200,China)

机构地区：[1]北京大学第一医院男科中心,北京100034 [2]湘潭县人民医院泌尿外科,湖南湘潭411200

出　　处：《中华男科学杂志》2022年第10期891-895,共5页National Journal of Andrology

摘　　要：目的:回顾性评估彩色多普勒超声对阴茎海绵体白膜破裂的诊断准确率及价值,分析影响预后的因素。方法:选取北京大学第一医院2013~2021年收治的57例阴茎海绵体白膜破裂患者作为研究对象,通过收集术前彩色多普勒超声对破口位置、大小、数目、有无尿道损伤以及术中情况,进行对比分析来评估彩色多普勒超声的准确率及价值。结果:57例患者彩色多普勒超声均提示有白膜损伤,术中探查发现54例有白膜损伤,3例无白膜损伤,彩色多普勒超声诊断准确率(54/57,94.7%);彩色多普勒超声提示2例为双侧损伤,术中发现7例为双侧损伤;彩色多普勒超声提示6例尿道损伤,术中发现13例合并尿道损伤。尿道损伤患者经一期尿道修补术后随访至今均未出现尿道狭窄和尿瘘,1年后随访无中重度ED发生。结论:虽然不能代替病史和查体的诊断价值,不能作为是否手术的金标准,超声检查仍存在一定价值,超声对于海绵体白膜破裂的诊断率准确率较高,并在选择手术切口位置时有参考价值。Objective: To assess the accuracy and value of ultrasonography in the diagnosis of ruptured tunica albuginea(RTA) of the corpus cavernosum penis. Factors affecting prognosis were analyzed. Methods: This retrospective study included 57 cases of RTA of the corpus cavernosum penis ultrasonographically diagnosed and surgically treated in Peking University First Hospital from 2013 to 2021. We analyzed the location, size and number of ruptures and the presence or absence of urethral injury, and compared the intraoperative with the ultrasonographic findings. Results: Of the 57 cases of RTA of the corpus cavernosum penis diagnosed by ultrasonography, 54(94.7%) were confirmed by surgery. Preoperative ultrasonography indicated 2 cases of bilateral RTA and 6 cases of urethral injury, while surgery revealed 7 cases of bilateral RTA and 13 cases of combined urethral injury. Those with urethral injury developed no urethral stricture or urinary fistula after one-stage urethral repair. And no severe or moderate ED was found in any of the patients during the 12-month follow-up. Conclusion: Ultrasonography has a high accuracy in the diagnosis of ruptured tunica albuginea of the corpus cavernosum penis, and contributes to the determination of the site of surgical incision.

关 键 词：阴茎折断 尿道损伤 彩色多普勒超声 勃起功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R697.1[医药卫生—诊断学]