阴茎神经电生理检查对早泄临床分型与治疗的指导作用  

Guiding effect of penile nerve electrophysiological examination on clinical classification and treatment of premature ejaculation

作　　者：傅柳铭 汪柳霞[2] 朱文平 李陆义 王松松 刘子明[1] FU Liuming;WANG Liuxia;ZHU Wenping;LI Luyi;WANG Songsong;LIU Ziming(Department of Urology,Zhongshan Hospital Affiliated to Xiamen University,Fujian,361004,China;Department of Neuroelectrophysiology,Zhongshan Hospital Affiliated to Xiamen University)

机构地区：[1]厦门大学附属中山医院泌尿外科,福建厦门361004 [2]厦门大学附属中山医院神经电生理室,福建厦门361004 [3]福建医科大学附属漳州市医院

出　　处：《临床泌尿外科杂志》2025年第2期168-173,共6页Journal of Clinical Urology

基　　金：厦门市自然科学基金面上项目(No:3502Z202373102)。

摘　　要：目的:通过采用阴茎神经电生理检查对早泄患者进行分型及按分型给予相应的治疗方案,并与经验性治疗的早泄患者相比较,探讨阴茎神经电生理检查对早泄临床分型及治疗的指导作用。方法:回顾性收集2021年6月—2022年6月于厦门大学附属中山医院门诊就诊并符合纳入标准的早泄患者176例,其中行电生理检查的119例早泄患者纳入电生理组(A组),未行检查的57例患者纳入经验治疗组(B组)。根据电生理检查结果,将A组分成A_(1)组(中枢型)、A_(2)组(外周型)、A_(3)组(混合型)和A_(4)组(电生理正常型)。B组患者根据其性生活频率分为B_(1)、B_(2)组,性生活规律者为B_(1)组;性生活无规律者为B_(2)组。根据阴茎神经电生理分型及患者性生活规律制定治疗方案:A_(1)组规律口服盐酸帕罗西汀20 mg/次,1次/d并嘱其规律性生活;A_(2)组性生活前按需外用复方利多卡因乳膏;A_(3)组规律口服盐酸帕罗西汀及按需外用复方利多卡因乳膏(方案同A_(1)、A_(2)组)并嘱其规律性生活;A_(4)组给予性生活指导及心理疏导。B_(1)组规律口服盐酸帕罗西汀20 mg/次,1次/d;B_(2)组性生活前按需外用利多卡因乳膏。所有患者治疗4周,观察各组治疗前后阴道内射精潜伏期(intravaginal ejaculation latency time,IELT)、性生活满意度(sexual life satisfaction,SLS)、伴侣SLS、早泄诊断工具(premature ejaculation diagnostic tool,PEDT)评分评估治疗效果。对比分析治疗前后各组的治疗效果及治疗后相关配对组间的治疗效果(A_(1)组比B_(1)组、A_(2)组比B_(2)组、A_(3)组比B_(1)组、A_(3)组比B_(2)组、A_(4)组比B_(1)组、A_(4)组比B_(2)组)。结果:(1)与治疗前相比,6组患者治疗4周后IELT、SLS、伴侣SLS均较治疗前明显提高,PEDT评分均较治疗前明显降低,均差异有统计学意义(均P<0.05)。(2)治疗后各组间比较:A_(1)组比B_(1)组、A_(2)组比B_(2)组、A_(3)组比B_(1)组、A_(3)组比B_(2)组,�Objective:To explore the guiding role of penile nerve electrophysiological examination in the clinical classification and treatment of premature ejaculation.Patients with premature ejaculation were classified and given corresponding treatments according to the results of penile nerve electrophysiological examination,then compared them with patients with premature ejaculation treated empirically.Methods:From June 2021 to June 2022,176 patients with premature ejaculation who met the inclusion criteria were enrolled in the outpatient department of Zhongshan Hospital Affiliated to Xiamen University.Among them,119 patients with premature ejaculation who underwent electrophysiological examination were included in group A,while 57 without examination were included in group B.According to the results of electrophysiological examination,group A was then divided into subgroup A_(1)(central type),A_(2)(peripheral type),A_(3)(mixed type)and A_(4)(electrophysiological normal type).Patients in group B were divided into subgroup B_(1)and B_(2)according to their frequency of sexual life.Those with regular sexual life were subgroup B_(1),while those with irregular sexual life were in subgroup B_(2).According to the electrophysiological classification of penile nerve and the frequency of sexual life of patients,the treatment plan was formulated:subgroup A_(1)regularly took paroxetine 20 mg qd and instructed them to have sexual life regularly;A_(2)was treated with compound lidocaine cream on demand before sexual life;A_(3)regularly took paroxetine 20 mg and compound lidocaine cream for external use as needed(the same as subgroup A_(1)and subgroup A_(2))and instructed to have sexual life regularly;A_(4)was given sexual life guidance and psychological counseling.Subgroup B_(1)was given paroxetine 20 mg qd regularly and instructed them to have sexual life regularly;B_(2)was treated with lidocaine cream on demand before sexual life.All patients were treated for 4 weeks.The intravaginal ejaculation latency time(IELT),sexual life satisfa

关 键 词：早泄 阴茎神经电生理检查 分型 治疗 

分 类 号：R698[医药卫生—泌尿科学]