EECP联合小剂量PDE5i治疗有生育要求ED患者的临床分析

Analysis of the effect of EECP joint with small dose PDE5i for erectile dysfunction patients with fertility demands

目的探讨增强型体外反搏(EECP)联合小剂量5型磷酸二酯酶抑制剂(PDE5i)治疗有生育要求勃起功能障碍(ED)患者的治疗效果。方法选取2014年6月1日至2018年5月31日山东大学附属生殖医院泌尿外科和生殖男科诊治的197例有生育要求的ED患者作为研究对象。对这197例患者进行了EECP与小剂量PDE5i的联合治疗,我们回顾性分析了他们的一般资料、精液参数、配偶妊娠结局、治疗前与治疗后的IIEF-5评分和血压。结果患者治疗后的IIEF-5评分较治疗前有显著性升高,差异具有统计学意义(P<0.01),治疗后的收缩压较治疗前有显著性降低,差异具有统计学意义(P=0.013),治疗后的舒张压较治疗前的差异无统计学意义(P=0.144)。26例患者的配偶获自然妊娠,共获21个足月儿。结论EECP联合小剂量PDE5i可显著改善ED患者的勃起功能,使部分患者配偶获得自然妊娠,为有生育要求的ED患者提供了一种无创、经济、安全和有效的治疗方法。

Objective To investigate the treatment effect of enhanced external counterpulsation(EECP)and small dose phosphodiesterase type 5 inhibitor(PDE5i)for erectile dysfunction(ED)patients with fertility demands.Methods 197 ED patients with fertility demands in Center for Reproductive Medicine,Shandong University between June 1,2014 and May 31,2018 were selected and given EECP joint with small dose PDE5i.The baseline characteristics,hormonal parameters and semen parameters of the patients as well as the pregnancy outcome of the female partner were retrospectively reviewed and analyzed.Besides,the IIEF-5 score and blood pressure before and after the therapy were collected and analyzed accordingly.Results The IIEF-5 scores were significantly increased and the systolic pressure was significantly decreased after treatment,all with statistically signifant differences(P<0.01,P=0.013),while no statistically significant difference was found in diastolic pressure after treatment(P=0.144).26 female partners of the patients got naturally pregnant after treatment,and 21 term infants were deliveried.Conclusions EECP joint with small dose PDE5i can significantly improve the erectile function of ED patients,conductive to the pregnancy of their partners,which provides a noninvasive,economical,safe and effective way for ED patients with fertility demands.