阴茎背神经阻断术后神经离断的修复及疗效评价
发布时间：2019-03-10 21:33
【摘要】：目的探讨应用腓肠神经桥接移植修复阴茎背神经阻断术后神经离断的临床疗效。方法 2014年5月—2016年5月,采用腓肠神经桥接移植修复阴茎背神经阻断术后神经离断患者23例。患者年龄19~38岁,平均27岁。病程1~28个月,平均14个月。术前患者主要表现为阴茎性快感、冷热感觉及触觉敏感度减退等感觉障碍。21例患者自诉勃起障碍。所有患者激素水平正常,无其他器质性疾病,无手术禁忌证。根据症状自评量表-SCL90评估,患者存在抑郁19例、焦虑16例,其中焦虑及抑郁共存15例;其余心理异常情况(社交障碍等)3例。术中发现缺损神经总长度为1.0~1.5 cm。根据英国医学研究院神经外科学会感觉功能评定标准,评定静态两点辨别觉、感觉分级情况,记录性快感障碍、冷热感觉及触觉敏感度等主观感觉情况;对阴茎背神经阻断术后勃起功能采用国际勃起功能指数-5(IIEF-5)问卷调查表进行评估;应用症状自评量表-SCL90进行心理状态评估。结果术后患者切口均Ⅰ期愈合。23例患者均获随访,随访时间6~12个月,平均8个月。术后6个月性快感较术前明显改善11例,部分改善5例;冷热感觉及触觉敏感度改善21例;各方面均无明显改善1例。术后3、6个月患者静态两点辨别觉、感觉分级情况以及IIEF-5问卷调查表评定结果均较术前显著改善,比较差异有统计学意义(P0.05)。术后6个月根据症状自评量表-SCL90评估,与术前相比,抑郁改善14例(73.68%),焦虑改善12例(75.00%),焦虑和抑郁共存改善12例(80.00%)。结论腓肠神经桥接移植修复阴茎背神经阻断术后神经离断,可获得较好疗效。
[Abstract]:Objective to investigate the clinical effect of sural nerve bridging transplantation in the repair of nerve transection after dorsal penile nerve occlusion. Methods from May 2014 to May 2016, 23 patients with nerve transection after dorsal penile nerve occlusion were treated with sural nerve graft. The patients were 19 years old and 38 years old, with an average of 27 years old. The course of disease was 1-28 months (mean 14 months). Before operation, the patients mainly presented with sensorineural disorders such as penile pleasure, cold-hot sensation and decreased tactile sensitivity. 21 patients complained of erectile dysfunction. All patients with normal hormone levels, no other organic diseases, no surgical contraindications. According to symptom Checklist-SCL90 (SCL-90), there were 19 patients with depression, 16 patients with anxiety, 15 patients with anxiety and depression, and 3 patients with other mental disorders (social disorder, etc.). The total length of the nerve defect was found to be 1.0 to 1.5 cm. during the operation. According to the evaluation standard of sensory function of the Society of Neurosurgery of the British Medical Institute, subjective sensations such as static two-point discrimination, sensory grading, recording pleasure disorder, cold-hot sensation and tactile sensitivity were evaluated. The erectile function after penile dorsal nerve occlusion was assessed with the International erectile function Index-5 (IIEF-5) questionnaire, and the psychological status was evaluated by symptom Checklist-SCL90 (SCL-90). Results all of the 23 patients were followed up for 6 months and 12 months (mean 8 months). In 6 months after operation, sexual pleasure was improved in 11 cases, partial improvement in 5 cases, cold-heat sensation and tactile sensitivity improved in 21 cases, and no significant improvement in all aspects was found in 1 case. At 3 and 6 months after operation, the static two-point discrimination, sensory grading and IIEF-5 questionnaire were significantly improved compared with those before operation (P0.05). According to symptom Checklist-SCL90 (SCL-90), 14 cases (73.68%) improved depression, 12 cases improved anxiety (75.00%) and 12 cases improved both anxiety and depression (80.00%) 6 months after operation. Conclusion the peroneal nerve graft can be used to repair the nerve transection after dorsal penile nerve occlusion.
【作者单位】： 四川大学华西医院美容整形-烧伤外科;
【分类号】：R699.8
[Abstract]:Objective to investigate the clinical effect of sural nerve bridging transplantation in the repair of nerve transection after dorsal penile nerve occlusion. Methods from May 2014 to May 2016, 23 patients with nerve transection after dorsal penile nerve occlusion were treated with sural nerve graft. The patients were 19 years old and 38 years old, with an average of 27 years old. The course of disease was 1-28 months (mean 14 months). Before operation, the patients mainly presented with sensorineural disorders such as penile pleasure, cold-hot sensation and decreased tactile sensitivity. 21 patients complained of erectile dysfunction. All patients with normal hormone levels, no other organic diseases, no surgical contraindications. According to symptom Checklist-SCL90 (SCL-90), there were 19 patients with depression, 16 patients with anxiety, 15 patients with anxiety and depression, and 3 patients with other mental disorders (social disorder, etc.). The total length of the nerve defect was found to be 1.0 to 1.5 cm. during the operation. According to the evaluation standard of sensory function of the Society of Neurosurgery of the British Medical Institute, subjective sensations such as static two-point discrimination, sensory grading, recording pleasure disorder, cold-hot sensation and tactile sensitivity were evaluated. The erectile function after penile dorsal nerve occlusion was assessed with the International erectile function Index-5 (IIEF-5) questionnaire, and the psychological status was evaluated by symptom Checklist-SCL90 (SCL-90). Results all of the 23 patients were followed up for 6 months and 12 months (mean 8 months). In 6 months after operation, sexual pleasure was improved in 11 cases, partial improvement in 5 cases, cold-heat sensation and tactile sensitivity improved in 21 cases, and no significant improvement in all aspects was found in 1 case. At 3 and 6 months after operation, the static two-point discrimination, sensory grading and IIEF-5 questionnaire were significantly improved compared with those before operation (P0.05). According to symptom Checklist-SCL90 (SCL-90), 14 cases (73.68%) improved depression, 12 cases improved anxiety (75.00%) and 12 cases improved both anxiety and depression (80.00%) 6 months after operation. Conclusion the peroneal nerve graft can be used to repair the nerve transection after dorsal penile nerve occlusion.
【作者单位】： 四川大学华西医院美容整形-烧伤外科;
【分类号】：R699.8
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