朱策均 张月玲 谢淑慧 彭乃雄

【摘要】目的：评估彩色多普勒超声联合阴茎海绵体注射和听觉视觉性刺激在勃起功能障碍诊断中的临床应用价值。方法：对120例临床诊断为勃起功能障碍的患者进行阴茎海绵体内注射血管活性药物和辅助眼镜式影像仪给予听觉视觉性刺激，采用彩色多普勒超声测量阴茎海绵体动脉直径（CAD）、收缩期峰值流速（PSV） 、舒张末期流速（EDV） 、阻力指数（RI） 、背深静脉（DDV） 流速。结果：非血管性、动脉性和静脉性ED患者左右深动脉血流参数和注射前后阴茎海绵体动脉直径增大率差异无统计学意义（P>0.05）；彩色多普勒超声联合阴茎海绵体注射和听觉视觉性刺激在诊断动脉性血勃起功能障碍敏感度与特异度均为100%，诊断静脉性血勃起功能障碍敏感度为100%，特异度为96%。结论：彩色多普勒超声联合阴茎海绵体注射和听觉视觉性刺激在诊断各类型血管性ED及区别非血管性ED中具有较高的临床价值，值得推广应用。

【关键词】彩色多普勒超声；血管性勃起功能障碍；阴茎海绵体内注射；听觉视觉性刺激

The value of color doppler ultrasoundjoint intracavernous injection and visual -auditory sexual stimulation in diagnosis of patients with erectile dysfunctionZHU Cejun1， ZHANG Yueling1， XIE Shuhui1， PENG Naixiong2. 1. Department of Ultrasound， Longhua New District Central Hospital， Shenzhen 518110， Guangdong， China； 2. Department of Urology， Longhua New District Central Hospital， Shenzhen 518110， Guangdong， China

【Abstract】Objectives： To investigate the value of color doppler ultrasound joint intracavernous injection and visual -auditory sexual stimulation in diagnosis of patients with erectile dysfunction （ED）. Methods： 120 ED patients were injected with vasoactive drugs through the corpus cavernosum and given visual -auditory sexual stimulation. The cavernosum artery diameters （CAD）， peaks of the systolic velocity （PSV）， the end-diastolic veloeity （EDV）， resistant index （Rl） and flow rate of deep dorsal vein （DDV） were measured and compared before and after with color doppler ultrasounds. Results： Difference in left and right arterial blood flow parameters between all kinds of ED groups was not statistically significant， so as the increase in CAD after the treatment （P>0.05）. Both the sensitivity and specificity of color doppler ultrasound joint intracavernous injection and visual-auditory sexual stimulation in diagnosis of arterial ED patients was 100%， and the specificity decreased to 96% in the diagnosis of venous ED patients while the sensitivity remained 100%. Conclusion： Color doppler ultrasound after intracavernous injection and visual -auditory sexual stimulation has a great value for the diagnosis of various types of vaseular ED and discrimination of non-vaseular ED， which is worthy of clinical application.

【Key words】Color doppler ultrasound； Erectile dysfunction （ED）； Intracavernous injection； Visual-auditory sexual stimulation

【中图分类号】R698+.1【文献标志码】A

勃起功能障碍（erectile dysfunction，ED）是指阴茎受到刺激后勃起硬度不足以插入阴道或勃起维持的时间不足以满意地完成性生活，是最常见的男性性功能障碍之一，严重影响患者的家庭稳定性，给患者造成具体的心理压力[1-3]。勃起功能障碍的病因十分复杂，因此临床治疗首先要明确患者的病因，才能够取得良好的临床疗效[4]。动脉供血不足及静脉关闭不全以及静脉瘘是导致器质性勃起功能障碍的较为常见的因素，彩色多普勒超声在对血管性勃起功能障碍的诊断中具有无创、重复性好的优点，己成为临床鉴别血管性ED的重要手段。目前……