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目的:回顾分析体外震波疗法(ESWT)治疗佩罗尼氏病(Peyronie’s disease)患者的安全性和有效性。方法:53名稳定佩罗尼氏病人接受了 ESWT 治疗(组1),与组1患者基本特征相符的另外15名病人作为对照不接受治疗(组2)。记录组1病人勃起前后和组2病人随访期的勃起功能(5项国际勃起功能指标[IIEF-5]评分)、疼痛度(可视性评分标准,VAS)、斑块大小、阴茎弯曲角度。结果:组1和组2的平均随访时间分别为32个月(6—64个月)和35个月(9—48个月),所有病人都接受了随访。组1病人用 ESWT 治疗前后的勃起功能和斑块大小无显著差异(P>0.05)。组1中共有39名病人(74%)报告经 ESWT 治疗后疼痛度明显降低。但总体考虑疼痛改善程度、IIEF-5评分、斑块大小,未发现两组间有显著差异。组1中有21人(40%)阴茎偏移角度减少超过10.所有病人平均阴茎偏移角度为11(6—20).ESWT 治疗未引起严重并发症。结论:ESWT 治疗佩罗尼氏病伤害小、安全性高,但对阴茎疼痛、性功能、斑块大小的疗效仍有待商榷。
Objective: To retrospectively analyze the safety and efficacy of extracorporeal shock therapy (ESWT) in the treatment of patients with Peyronie’s disease. METHODS: Fifty-three stable Peyronie patients received ESWT (group 1), and another 15 patients who matched the basic characteristics of group 1 were not treated as controls (group 2). Erectile function (five International Index of Erectile Function [IIEF-5]), pain (VAS) score, plaque size, and penile curvature were recorded before and after the erection of Group 1 and during follow-up of Group 2 patients. RESULTS: The mean follow-up times for Group 1 and Group 2 were 32 months (6-64 months) and 35 months (9-48 months), respectively, and all patients were followed up. There was no significant difference in erectile function and plaque size before and after treatment with ESWT in group 1 (P> 0.05). A total of 39 patients (74%) in group 1 reported significantly reduced pain after ESWT treatment. However, overall improvement in pain, IIEF-5 score, plaque size, and no significant difference between the two groups were found. 21 (40%) in Group 1 had a reduction in the penile offset angle of more than 10. The mean penile offset angle for all patients was 11 (6-20) .ESWT did not cause serious complications. Conclusion: The treatment of Peyronie’s disease with ESWT is less harmful and safe, but the efficacy of penile pain, sexual function and plaque size remains to be discussed.