点状低能量体外冲击波治疗勃起功能障碍疗效的初步观察(附32例报告)

Focused low-intensity extracorporeal shock wave therapy for erectile dysfunction: Preliminary observation of 32 cases

目的:初步探讨点状体外低能量冲击波(LI-ESWT)治疗勃起功能障碍(ED)患者的安全性和疗效。方法:选取在我院就诊的采用ED1000治疗的ED患者32例,分别在治疗前和治疗后4周、12周随访评估患者的勃起功能专项评分(IIEF-EF)、勃起硬度分级(EHS)、性生活日志问题2(SEP2),性生活日志问题3(SEP3)、总体评估问卷(GAQ)和不良反应发生率。结果:32例患者平均年龄30.69岁,基线IIEF-EF平均14.94分,治疗后4周、12周随访分别为20.97分和21.47分,与基线水平比较明显改善(P<0.01)。EHS评分基线平均1.75,治疗后4周、12周分别为2.66和2.56,与治疗前比较有明显改善(P<0.01)。治疗前患者SEP2、SEP3回答"能"为21.88%和0,治疗后4周和12周SEP2分别为68.75%和71.88%,SEP3分别为43.75%和56.25%。GAQ问卷回答"有"治疗后4周和12周分别为GAQ1 81.25%和71.88%;GAQ2 65.63%和68.75%;治疗4周和12周总有效率分别为75%和71.88%。1例患者在治疗后出现阴茎体部疼痛,有少量皮下出血瘀斑,未做特殊治疗,1周后痊愈。结论:LI-ESWT治疗后12周内可以明显改善ED患者的勃起功能,且无明显不良反应。

Objective： To make a preliminary investigation on the safety and efficacy of focused low-intensity extracorporeal shock wave therapy （LI-ESWT） in the treatment of erectile dysfunction （ED）. Methods ： We treated 32 ED patients by focused LI- ESWT with the device of Medispecg ED1000. Before and at 4 and 12 weeks after treatment, we evaluated the erectile function of the patients using the International Index of Erectile Function-erectile function domain （IIEF-EF）, Erection Hardness Score （EHS）, Sexual Encounter Profile questions 2 and 3 （ SEP2 and SEP3 ）, and Global Assessment Questionnaire questions 1 and 2 （ GAQ1 and GAQ2）, and recorded the incidence rate of adverse events. Results ： The patients averaged 30.69 years of age. Compared with the baseline, the mean IIEF-EF score of the patients was significantly increased at 4 and 12 weeks after LI-ESWT （14.94 vs 20.97 and 21.47, P 〈0.01）, and so were the EHS （1.75 vs 2.66 and 2.56, P 〈0.01） and the ＂Yes＂ answers to SEP2 （21.88% vs68.75% and 71.88%）, SEP3 （0vs43.75% and 56.25%）, GAQI （NAys81.25% and 71.88%） and GAQ2 （NAys65.63% and 68.75% ）. The total effectiveness rates at 4 weeks and 12 weeks were 75% and 71.88% respectively. One of the patients felt penile shaft pain with mild eeehymosis after LI-ESWT but was recovered without special treatment a week later. Conclusion： LI-ESWT can significantly improve the erectile function of ED patients with no obvious adverse effects within 12 weeks after treatment.