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頁籤選單縮合
| 題 名 | Dynamic Infusion Cavernosometry and Cavernosography (DICC) in the Evaluation of Vasculogenic Impotence=陽萎之陰莖海綿體壓力測量及海綿體攝影血流動力學研究 |
|---|---|
| 作 者 | 陳光國; 陳明村; 駱光裕; 張心湜; | 書刊名 | 中華醫學雜誌 |
| 卷 期 | 57:4 1996.04[民85.04] |
| 頁 次 | 頁266-273 |
| 分類號 | 415.85 |
| 關鍵詞 | 陽萎; 陰莖勃起; 前列腺素E1; 靜脈; Impotence; Penile erection; Prostaglandin E1; Vein; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景:為了對陽萎病人之陰莖血管作更準確及生理性之評估。 方法:22位年齡25-76歲(平均54歲)之陽萎病人接受了動態性灌注陰莖海綿體測壓及海綿體放射線攝影檢查,以研究陰莖勃起之血流動力學,及確定其陰莖之動脈及或靜脈功能是否正常。在此四階段之研究中,係採用陰莖海綿體內注射前列腺素E1。 結果:在所有22位病人中,此項血管檢查並未有副作用或併發症發生。在第一階段檢查發現平均靜態海綿體內壓為6.8+/-3.6毫米汞柱,注射前列腺素E1後,平均穩定增加之海綿體內壓為47.2+/-23.9毫米汞柱。穩定海綿體內壓對平均動脈壓之平均比值為50.2+/-23.4%。在第二階段之檢查中,停止生理食鹽水之灌注30秒後,其平均海綿體內壓為65.3+/-26.8毫米汞柱,如壓迫會陰部,則海綿體內壓為129.1+/-26.2毫米汞柱。因此,海綿體內壓由150毫米汞柱平均掉落84.7+/-26.8毫米汞柱。第三階段之檢查發現左側海綿體動脈之平均收縮壓為87.6+/-18.9毫米汞柱,而右側為93.6+/-17.6毫米汞柱。海綿體動脈及臂動脈收縮壓之平均比值在左側為70.1+/-12.7%,而右側為75.1+/-11.5%。有六位病人此項比值超過75%,其陰莖動脈都卜勒超音波檢查皆正常(海綿體動脈直徑超過0.9毫米,而最大血流速大於25公分╱秒)。在第四階段之檢查發現22位病人中,有20位(90.9%)海綿體內壓滑落超過60毫米汞柱,其放射線攝影顯示有靜脈漏;另外兩位病人其海綿體內壓滑落小於45毫米汞柱,則沒有靜脈漏。 結論:在陰莖動脈功能不足之病人,其海綿體內壓與臂動脈壓之比值通常是小於75%。當海綿體內壓由150毫米汞柱滑落超過60毫米汞柱時,其海綿體攝影檢查會顯現靜脈漏。在本研究中,海綿體測壓及海綿體放射線攝影具有相當高之關連性。動態性灌注海綿體測壓與海綿體攝影為一更具生理性及準確性之評估,對於診斷血管性陽萎提供了一良好的檢查。 |
| 英文摘要 | Background: This study was conducted to find more accurate physiological assessment of the penile vascular status in impotent patients. Methods. Twenty-two males, aged 25-76 years (mean 54.0 years) with possible underlying vascular causes of impotence, had dynamic infusion cavernosometry and cavernosography (DICC) examination to ascertain the arterial and/or venous insufficiency in the penis. Prostaglandin E1 20 micron g was injected intracavernously in this 4-phase study. Results: No side effect or complication was noted during or after the examination in all 22 patients. During the phase 1 test, the mean resting intracavernous pressure (ICP) was 6.8 +/- 3.6 mmHg and the mean plateau ICP after PGE1 injection was 47.2 +/- 23.9 mmHg. The mean ratio of plateau ICP to mean arterial pressure was 50.2 +/- 23.4%. In the phase 2, the mean ICP determined 30 seconds after cessation of saline infusion without and with perineal compression was 65.3 +/- 26.8 mmHg and 129.1 +/- 26.2 mmHg, respectively. The mean ICP decay from 150 mmHg was 84.7 +/- 26.8 mmHg. The mean systolic pressure of each cavernous artery, 87.6 +/- 18.9 mmHg and 93.6 +/- 17.6 mmHg in left and right side, respectively, was found during phase 3 evaluation. The mean ratio of systolic pressure of each cavernous artery to brachial artery (cavernous-brachial index, CBI) was 70.1 +/- 12.7% and 75.1 +/- 11.5% in left and right side, respectively. Six patients with CBI greater than 75% had normal Doppler duplex sonography (diameter of cavernous artery greater than 0.9 mm and peak flow velocity greater than 25 cm/sec). Cavernosography in phase 4 evaluation showed venous leakage in 20 of 22 patients (90.9%) with ICP decay greater than 60 mmHg. Two patients with ICP decay less than 45 mmHg were found to have no venous leakage. Conclusions: The cavernous-brachial index is usually less than 75% in penile arterial insufficiency. The patients with ICP decay from 150 mmHg greater than 60 mmHg would have penile venous leakage demonstrated in the cavernosography. The results of cavernosometry are highly correlated with cavernosography. Our results suggest that DICC may provide a good examination for more physiological assessment and accurate diagnosis of vasculogenic impotence. |
本系統中英文摘要資訊取自各篇刊載內容。