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目的 探讨动脉外伤性勃起功能障碍的诊断和治疗。方法 4例骨盆骨折外伤引起阴茎动脉供血受损所致ED ,阴茎海绵体血管活性药物注射后仅见阴茎轻度胀大 ,球海绵体肌反射试验正常。并行药物性阴茎多谱勒超声检查 (PPDU)和药物性阴部内动脉造影检查 (IPA) ,其中 3例行腹壁下动脉和阴茎背浅动脉吻合术。结果 术前PPDU和IPA显示 ,1例双侧海绵体动脉及血流均未显示 ,左侧阴部内动脉和右侧阴茎动脉主干断裂 ,2例双侧海绵体动脉血管均低于正常 ,双侧阴部内动脉及阴茎动脉主干未显示明显异常。 1例右侧海绵体动脉血流正常 ,左侧海绵体动脉血流明显低于正常 ,左右海绵体动脉近端有交通枝 ,左侧阴茎动脉主干断裂。 3例手术后随访 ,1例完全恢复正常自然勃起 ,2例阴茎海绵体血管活性药物注射后阴茎达正常勃起。结论 骨盆骨折可造成阴茎勃起血供受损 ,阴茎动脉旁路手术为一有可能达到永久治愈单纯动脉外伤性勃起障碍的方法
Objective To investigate the diagnosis and treatment of arterial traumatic erectile dysfunction. Methods 4 cases of pelvic fractures caused by penile artery injury caused by ED, penile cavernous vasoactive drug injection only slightly swollen penis, ball sponge muscle reflex test was normal. Parallel drug penile doppler ultrasonography (PPDU) and drug-induced intravaginal arteriography (IPA) were performed, of which 3 underwent anastomosis of inferior abdominal artery and penis dorsal superficial artery. Results Preoperative PPDU and IPA showed that no bilateral cavernous arteries and blood flow were shown in either of the two groups. The left genu of the penis and the right penile artery were ruptured. The bilateral cavernous arteries in two cases were lower than normal and both sides Intra-genital artery and penile artery trunk did not show significant abnormalities. One case of right cavernous artery blood flow was normal, left cavernous artery blood flow was significantly lower than normal, left and right cavernous artery proximal traffic branches, left main penile artery rupture. Three patients were followed up after surgery. One patient completely recovered from normal spontaneous erection. Two patients with penile cavernous vasoactive drug injected normal erection. Conclusion pelvic fractures can cause penile erection blood supply damage, penile artery bypass surgery is likely to achieve a permanent cure pure artery traumatic erectile dysfunction