法医学杂志

法医学杂志 ›› 2015, Vol. 31 ›› Issue (5): 369-372.DOI: 10.3969/j.issn.1004-5619.2015.05.010

• 案例分析 • 上一篇    下一篇

58例神经性勃起功能障碍法医学分析（英文）

朱广友1，沈  彦1，刘洪国2   

  1. （1． 司法部司法鉴定科学技术研究所 上海市法医学重点实验室，上海 200063； 2. 上海市卫生和计划生育委员会，上海 200125）
  • 发布日期:2015-10-25 出版日期:2015-10-28

Forensic Medical Assessment for Neurologic Erectile Dysfunction: 58 Case Reports

ZHU GUANG-YOU1, SHEN YAN1, LIU HONG-GUO2   

  1. （1. Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai 200063, China; 2. Shanghai Municipal Commission of Health and Family Planning, Shanghai 200125, China）
  • Online:2015-10-25 Published:2015-10-28
  • About author:ZHU Guang-you （1953—）, research fellow, postgraduate in forensic medicine; E-mail: zhugy@ssfjd.cn

摘要： 通过运用神经系统检查来评估58例患者的勃起功能，简单介绍我所评估神经性勃起功能障碍（erectile dysfunction，ED）的方法和步骤。神经性勃起功能障碍的诊断标准：有明确的神经系统外伤或疾病史，有功能障碍的临床表现和体征，有神经电生理学传导障碍，阴茎夜间勃起硬度测试（nocturnal penile tumescence and rigidity，NPTR）示阴茎平均硬度<60%，持续时间<10 min。在20例有脑部、脊髓或脊髓根损伤的患者中，通过阴部皮层体感神经诱发电位（pudendal cortical somatic evoked potential，PCSEP）、骶髓生殖反射时（sacral reflex latency，SRL）、阴部皮层运动诱发电位（pudendal-to-cortical motor evoked potential，PCMEP）、阴茎皮肤交感反应（penile sympathetic skin responses，PSSR）和NPTR检测，存在ED的比例分别为45%、20%、20%、85%和85%。在38例有骨盆损伤伴尿道断裂损伤的患者中，通过PCSEP、SRL、PCMEP、PSSR和NPTR检测，存在ED的比例分别为24%、5%、20%、92%和66%。在20例有脑部、脊髓或脊髓根损伤的患者中，35%为重度ED，50%为中度ED。在38例有骨盆损伤伴尿道断裂损伤的患者中，21%为重度ED，13%为中度ED，37%为轻度ED。这些方法在评估神经性ED中具有良好的特异性和可靠性。

关键词: 法医学, 勃起功能障碍, 案例分析

Abstract: To introduce the approaches and procedures of neurologic erectile dysfunction （ED） assessment in our institute, and evaluate the neurologic investigation by making an analysis of 58 cases. Diagnostic criteria of neurologic ED: nervous system injuries or diseases, abnormal clinical symptoms and signs, electrophysiological abnormalities of nervous system, abnormal results of nocturnal penile tumescence and rigidity （NPTR） （penis rigidity <60% and lasting time <10 minutes）. In the group of 20 patients with the injuries of the brain, spinal cord or spinal root nerves, pudendal cortical somatic evoked potential （PCSEP）, sacral reflex latency （SRL）, pudendal-to-cortical motor evoked potential （PCMEP）, penile sympathetic skin responses （PSSR） and NPTR showed abnormality by 45%, 20%, 20%, 85% and 85%, respectively. In 38 patients with the injuries of pelvic fracture with urethra break, PCSEP, SRL, PCMEP, PSSR and NPTR showed abnormality by 24%, 5%, 20%, 92% and 66%, respectively. In the former, 35% were identified to have severe ED, and 50%, moderate ED; in the latter, 21%, to have severe ED, 13%, medium ED, and 37%, light ED. The approaches and procedures were proved to possess excellent specificity and reliability in the assessment of neurological ED.

Key words: forensic medicine, erectile dysfunction, cases analysis

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