【目的】探讨高海拔缺氧地区应用精准电生理诊断与经皮低频电刺激治疗阴茎硬结症的效果及治疗方案。【方法】回顾性分析纳入电生理诊断与治疗阴茎海绵体硬结症患者共54例。年龄20~70岁,平均(45.5±11.6)岁,病程2~16月。治疗前均口服...【目的】探讨高海拔缺氧地区应用精准电生理诊断与经皮低频电刺激治疗阴茎硬结症的效果及治疗方案。【方法】回顾性分析纳入电生理诊断与治疗阴茎海绵体硬结症患者共54例。年龄20~70岁,平均(45.5±11.6)岁,病程2~16月。治疗前均口服PDE5i、左卡尼汀口服液、活血化瘀中药等,治疗前停所有口服药物1周后进行可视化精准电生理诊断,记录并对比设定治疗前后电生理诊断参数,调整精准电生理相应参数进行经皮低频电刺激治疗,每次2~3 h、每日1次、每疗程10次。同时辅助鼻导管吸氧2~3 h(4 L/min)。电生理诊断与治疗前后应用《疼痛程度数字评估量表》、勃起功能国际问卷-5(IIEF-5)、阴茎弯曲度测量、阴茎彩色多普勒测量斑块面积大小及全身与疾病局部红外热像图温度变化对比评估。【结果】所有患者均顺利完成经皮低频电刺激治疗2~4疗程(20~40次)。疲软/勃起疼痛程度治疗前后均值对比(7.1±1.6 vs 2.0±1.0),差异有统计学意义(P<0.01);IIEF-5治疗前后均值对比(8.2±3.2 vs 16.0±5.1),差异有统计学意义(P<0.01);PCDDU测量斑块面积治疗前后均值对比0.23(0.09~0.54)cm^(2) vs 0.23(0.09~0.54)cm^(2),改善值无变化,差异无统计学意义(P=0.189);4例无阴茎弯曲畸形,电刺激治疗前50例(92.6%)患者有不同程度的阴茎弯曲畸形,治疗前后对比弯曲角度改善无变化,差异无统计学意义(P>0.05)。可视化精准电生理诊断治疗前后比较TMT图提示全身及阴茎、双侧腹股沟区等温度变化>1.5℃,属于有效电刺激治疗。随访3~10个月无复发硬结、疼痛和阴茎弯曲畸形加重、无1例患者需要后续手术。【结论】本研究结果发现可视化电生理诊断情况设定局部与整体相结合治疗参数,通过中医经络穴位、神经肌肉经皮低频电刺激治疗佩罗尼氏病(PD)安全性良好、疗效肯定,特别是在早期阶段对疼痛治疗效果明显,为PD治疗开辟了新途径。展开更多
The aim of this study was to determine possible correlations between the clinical characteristics, electrophysiological features, and sonographic ulnar nerve diameter in patients with ulnar neuropathy at the elbow (UN...The aim of this study was to determine possible correlations between the clinical characteristics, electrophysiological features, and sonographic ulnar nerve diameter in patients with ulnar neuropathy at the elbow (UNE). We prospectively performed clinical, electrodiagnostic, and sonographic studies in 102 patients having either purely sensory signs (35% ) or sensorimotor signs (65% ) of UNE. Nerve conduction studies had a sensitivity of 78% , and the addition of sonography increased this to 98% . The diagnostic value of both tests was not different among cases with and without motor deficit. Motor studies with recording from the abductor digiti minimi and first dorsal interosseousmuscles were equally sensitive for the detection of conduction block or velocity slowing across the elbow, but the combination yielded more positive cases than when only one study was performed. There were modest negative correlations between the electrodiagnostic parameters and the sonographic ulnar nerve diameter. Electrodiagnostically and sonographically, there were no significant differences between clinically pure sensory and mixed sensorimotor cases of UNE, except for electrodiagnostic findings suggesting loss of motor axons in cases with motor signs. Almost half the patients with only sensory signs had electromyographic evidence of motor axonal loss. We conclude that, although UNE is clinically heterogeneous, the electrophysiological and sonographic findings are fairly consistent despite the clinical manifestations.展开更多
文摘【目的】探讨高海拔缺氧地区应用精准电生理诊断与经皮低频电刺激治疗阴茎硬结症的效果及治疗方案。【方法】回顾性分析纳入电生理诊断与治疗阴茎海绵体硬结症患者共54例。年龄20~70岁,平均(45.5±11.6)岁,病程2~16月。治疗前均口服PDE5i、左卡尼汀口服液、活血化瘀中药等,治疗前停所有口服药物1周后进行可视化精准电生理诊断,记录并对比设定治疗前后电生理诊断参数,调整精准电生理相应参数进行经皮低频电刺激治疗,每次2~3 h、每日1次、每疗程10次。同时辅助鼻导管吸氧2~3 h(4 L/min)。电生理诊断与治疗前后应用《疼痛程度数字评估量表》、勃起功能国际问卷-5(IIEF-5)、阴茎弯曲度测量、阴茎彩色多普勒测量斑块面积大小及全身与疾病局部红外热像图温度变化对比评估。【结果】所有患者均顺利完成经皮低频电刺激治疗2~4疗程(20~40次)。疲软/勃起疼痛程度治疗前后均值对比(7.1±1.6 vs 2.0±1.0),差异有统计学意义(P<0.01);IIEF-5治疗前后均值对比(8.2±3.2 vs 16.0±5.1),差异有统计学意义(P<0.01);PCDDU测量斑块面积治疗前后均值对比0.23(0.09~0.54)cm^(2) vs 0.23(0.09~0.54)cm^(2),改善值无变化,差异无统计学意义(P=0.189);4例无阴茎弯曲畸形,电刺激治疗前50例(92.6%)患者有不同程度的阴茎弯曲畸形,治疗前后对比弯曲角度改善无变化,差异无统计学意义(P>0.05)。可视化精准电生理诊断治疗前后比较TMT图提示全身及阴茎、双侧腹股沟区等温度变化>1.5℃,属于有效电刺激治疗。随访3~10个月无复发硬结、疼痛和阴茎弯曲畸形加重、无1例患者需要后续手术。【结论】本研究结果发现可视化电生理诊断情况设定局部与整体相结合治疗参数,通过中医经络穴位、神经肌肉经皮低频电刺激治疗佩罗尼氏病(PD)安全性良好、疗效肯定,特别是在早期阶段对疼痛治疗效果明显,为PD治疗开辟了新途径。
文摘The aim of this study was to determine possible correlations between the clinical characteristics, electrophysiological features, and sonographic ulnar nerve diameter in patients with ulnar neuropathy at the elbow (UNE). We prospectively performed clinical, electrodiagnostic, and sonographic studies in 102 patients having either purely sensory signs (35% ) or sensorimotor signs (65% ) of UNE. Nerve conduction studies had a sensitivity of 78% , and the addition of sonography increased this to 98% . The diagnostic value of both tests was not different among cases with and without motor deficit. Motor studies with recording from the abductor digiti minimi and first dorsal interosseousmuscles were equally sensitive for the detection of conduction block or velocity slowing across the elbow, but the combination yielded more positive cases than when only one study was performed. There were modest negative correlations between the electrodiagnostic parameters and the sonographic ulnar nerve diameter. Electrodiagnostically and sonographically, there were no significant differences between clinically pure sensory and mixed sensorimotor cases of UNE, except for electrodiagnostic findings suggesting loss of motor axons in cases with motor signs. Almost half the patients with only sensory signs had electromyographic evidence of motor axonal loss. We conclude that, although UNE is clinically heterogeneous, the electrophysiological and sonographic findings are fairly consistent despite the clinical manifestations.
