低流量型阴茎异常勃起的急诊处理（附13例报告）

The emergency treatment of low flow priapism （report of 13 cases）

目的探讨低流量型阴茎异常勃起的诊断和治疗方法。方法回顾性分析13例阴茎异常勃起患者的临床资料。所有患者均为低流量型，持续勃起时间6～150h，平均35h。保守治疗6例，手术治疗7例。结果经治疗后，9例（69．2％）勃起完全消退，3例（23．1％）部分消退，1例（7．7％）转移性癌症所致勃起治疗无效。11例随访2～37个月，平均14．1个月，8例恢复正常勃起功能，2例出现勃起功能障碍（ED），2例失访。结论阴茎海绵体穿刺抽血行血气分析、海绵体彩色多普勒超声检查等有助于阴茎异常勃起准确及时诊断。对于勃起持续时间在24h以内者，采取有效非手术手段解除病理性勃起，可以避免继发不可逆转的阴茎勃起障碍；对于上述治疗无效或勃起持续时间超过24h患者，可直接选择手术治疗，以免延误有效的治疗时机。

Objective To explore the diagnosis and treatment of low flow priapism. Methods Clinical data of 13 patients with low flow priapism were retrospectively analyzed. All the cases were diagnosed as low flow priapism with a mean duration of 35hs, ranging from 6 to 150h. Six cases received non-surgical treatment and 7 cases surgical treatment. Results After treatment, 9 cases （69.2%） had complete detumescence, 3 cases （23.1%） had partial deturmescence, 1 case （7.7%） with tumor metastasis had no resolution. After a follow-up in 11 cases for 2 to 37 months （mean 14.1 minths）, normal erection occurred in 8 cases, ED in 2 cases, lost to follow-up in 2cases. Conclusion The cavernosal blood analysis and color Doppler ultrasound examination show great values in diagnosis of low flow priapism. Proper early interventions for patient with priapism within 24 h could prevent irreversible erectile dysfunction efficaciously. For patients with priapism over 24 h, surgical treatment could be applied directly to preserve the erectile function.