CAJ | 학술논문

目的：观察和评价阴茎体感诱发电位在筛选和指导阴茎高敏感性早泄患者阴茎背神经切断术治疗的临床价值。方法对本院2012年10月至2013年5月使用神经电生理筛选出阴茎背神经体感诱发电位（DNSEP）潜伏期＜40.83ms的21例早泄患者行阴茎背神经切断术。术后4周开始性生活，术后3个月复查神经电生理，比较手术前后的DNSEP和阴茎头体感诱发电位（GPSEP）的潜伏期及波幅的变化，评价阴道内射精潜伏期（IELT）和性生活满意度。同时，观察切口不良反应。结果 IELT延长显效（≥5min）8例，好转（≥2min）11例，无效（＜2min）2例，总有效率为90.48%，术后阴茎麻木感2例，包皮水肿1例。术后性生活满意度评分明显改善，DNSEP和GPSEP的潜伏期延长， GRSEP波幅降低，与术前比较均具统计学意义（P＜0.05），而DNSEP波幅变化与术前比较，无统计学意义。结论阴茎体感诱发电位（DNSEP和GPSEP）可客观地筛选出阴茎高敏感性的早泄患者，为阴茎背神经切断术治疗早泄提供客观的筛查方法。
목적：관찰화평개음경체감유발전위재사선화지도음경고민감성조설환자음경배신경절단술치료적림상개치。방법대본원2012년10월지2013년5월사용신경전생리사선출음경배신경체감유발전위（DNSEP）잠복기＜40.83ms적21례조설환자행음경배신경절단술。술후4주개시성생활，술후3개월복사신경전생리，비교수술전후적DNSEP화음경두체감유발전위（GPSEP）적잠복기급파폭적변화，평개음도내사정잠복기（IELT）화성생활만의도。동시，관찰절구불량반응。결과 IELT연장현효（≥5min）8례，호전（≥2min）11례，무효（＜2min）2례，총유효솔위90.48%，술후음경마목감2례，포피수종1례。술후성생활만의도평분명현개선，DNSEP화GPSEP적잠복기연장， GRSEP파폭강저，여술전비교균구통계학의의（P＜0.05），이DNSEP파폭변화여술전비교，무통계학의의。결론음경체감유발전위（DNSEP화GPSEP）가객관지사선출음경고민감성적조설환자，위음경배신경절단술치료조설제공객관적사사방법。
Objective To observe and evaluate the value and efficiency of penial somatosensory evoked potential in premature ejaculation with penile hypersensitivity. Methods penile dorsal nerve neurotomy was performed in 21 patients (latency of DNSEP less than 40.83s) admitted to our department from October 2012 to May 2013.Four weeks after operation, the patients could have sexual life.Three months after operation, the latencies and amplitudes of GPSEP/DNSEP were measured. The patients were followed up for 3 months, during which ejaculation latency and sexual life satisfaction degree were recorded and evaluated.Meanwhile,adverse reactions at the incision were observed. Results The ejaculation latency was significantly prolonged in 8,improved in 11 but not improved in 2 patients,with a total effective rate of 90.48%. One case of foreskin edema and two cases of penis numb were observed during the follow-up.After penile dorsal nerve neurotomy, sexual life satisfaction degree in patients had been significantly improved (P<0.05), and mean latencies of DNSEP and GRSEP were significantly longer (P<0.05), mean amplitude of GRSEP was significantly lower (P<0.05), but mean amplitude of DNSEP had no significant difference. Conclusion Penile dorsal nerve neurotomy can effectively reduce the sensibility of penis, prolong ejaculation latency and improve the sexual satisfaction.Premature ejaculation with penile hypersensitivity can be identified through penial somatosensory evoked potential.It provides a screening method for penile dorsal nerve neurotomy.