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目的：研究彩色多普勒超声(CDDS)在血管性勃起功能障碍(ED)中的诊断价值，从而为患者临床诊断方式的选择提供参考。方法：选择本院内2012 年4 月至2015 年3 月期间因ED 入院接受治疗的男性患者248 例，在患者接受检查前，需将酚妥拉明、罂粟碱以及前列腺素-E1 等药物混合液0.2 mL注入阴茎海绵体内，使得诱导阴茎勃起，随后使用彩色多普勒超声系统进行诊断，对阴茎海绵体动脉的收缩期最大血流率（PSV）、舒张末期血流率(EDV)、阻力指数（RI）等指标进行记录，对各指标诊断ED的应用价值进行评估。结果：在248 例患者中，存在血流动力学异常病例172 例，其中96 例患者为动脉性ED, 72 例患者为静脉性ED；72 例血流动力学正常病例，为非血管性ED。合并糖尿病25 例，占10.08%；高血压17 例，占6.85%；高血脂116 例，占46.77%；阴茎硬结症7 例，占2.82%；阴茎海绵体纤维化8 例，占3.23；经腹前列腺切除术后者9 例，占3.2%，经尿道切除前列腺术后者8 例，占 3.23；吸烟者196 例，占79.03%。血管性ED患者的FPSV、PSV、EDV明显低于非血管性ED 患者的，差异均有统计学意义(P<0. 05)；且在血管性ED患者中，动脉性FPSV 、ED、EDV患者的PSV 明显低于非血管性ED 患者的，差异均有统计学意义(P<0.05)。在指标对比中，血管性ED 患者的RI与非血管性ED 患者的RI 无明显差异(P>0.05)，但静脉性ED 患者的RI 明显低于非血管性 ED 患者的，差异均有统计学意义(P<0.05)。在96例动脉性ED 患者中，行选择性阴部内动脉造影术有11 例，动脉性病变8 例，彩色超声多普勒检查与选择性阴部内动脉造影术符合率为72. 73%。结论：在诱导阴茎勃起后，对患者进行彩色多普勒超声系统诊断，能够有效排除阴茎在疲软状态下存在的可变性因素，能够准确反映阴茎血流动力学状态，从而能够准确筛查血管性ED疾病，其检测结果的准确性优于动脉造影，临床应用价值较高，值得进一步推广使用。

英文摘要:

Objective:To study the diagnostic value of Color Duplex Doppler ultra sound (CDDS) in patients with Dysfunction Erectile (ED), and to provide a reference for clinical diagnosis.Methods:A total of 248 male patients with ED, who were admitted to Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from April 2012 to March 2015, were selected. Before detection, phenol phentolamine, papaverine and prostaglandin E1 and so on were mixed into 0.2 mL liquid and injected into the cavernous body of cavernous bodies to induce penile erection, which were detected by color Doppler ultrasound; the cavernosa arterial systolic penis systolic velocity (PSV), end diastolic velocity (EDV), resistant index, (RI=PSV-EDV/PSV) and other indicators were recorded;the application value of each index was evaluated in the diagnosis of erectile dysfunction (ED).Results:Among 248 patients, there were 172 cases of abnormal hemodynamics ( including 96 cases of arterial ED and 72 cases of venous ED); 72 cases of normal hemodynamics(non vascular ED); there were 25 of diabetes mellitus(10.08%), 17 cases of Hypertension (6.85%), 116 cases of Hyperlipidemia(46.77%), 7 cases of induration of penis(2.82%), 8 cases of cavernous fibrosis of penis(3.23), 9 cases of abdominal resection of the prostate(3.2%), 8 cases of postoperative transurethral resection of the prostate gland (3.23), 196 cases of smokers (79.03%). FPSV, PSV, EDV in vascular ED were obviously lower than those in non vascular ED, with statistically significant differences (P<0.05). In 96 patients with artery ED, there were 11 cases of selective pudendal artery angiography and 8 cases of arterial lesions; the coincidence rate of color doppler ultrasound examination and selective pudendal artery angiography was 72.73%.Conclusion:After the induction of penile erection, diagnosing the patients, by color Doppler ultrasound system, can effectively eliminate the variability of the penis in the weak state and accurately reflect the blood flow dynamics of the penis so as to accurately screen vascular ED diseases. Its accuracy is better than arterial angiography, which is worthy of clinical application.

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