目的：探讨阴茎定量感觉检测技术（包括温度觉及振动觉）在男性性功能障碍（包括勃起障碍及射精障碍）临床检测中的应用价值。方法运用以色列产TSA-II型定量感觉分析仪，以极限法（limit法）分别检测正常受试者（25例）、神经损伤后勃起障碍患者（50例）、神经损伤后射精困难患者（15例）阴茎头部、左手示指的热觉阈值、热痛觉阈值及振动觉阈值，并同时计算阴茎头部相对感觉阈值，即阴茎头部不同感觉阈值分别与左手示指感觉阈值的相对比值。同时进行神经诱发电位检测，比较两种检测方法的检出率。应用统计学软件进行组间分析比较。结果神经损伤后勃起障碍患者组阴茎头部热觉阈值、热痛阈值及相对阈值明显高于正常对照组，两组之间比较有统计学意义（P＜0.05）；神经损伤后勃起障碍患者组阴茎头部振动觉阈值及相对阈值明显高于正常对照组，两组之间比较有统计学意义（P＜0.05)。神经损伤后射精困难患者组阴茎头部热觉阈值、热痛阈值及相对阈值明显高于正常对照组，两组之间比较有统计学意义（P＜0.05）；神经损伤后射精障碍患者组阴茎头部振动觉阈值及相对阈值明显高于正常对照组，两组之间比较有统计学意义（P＜0.05）。神经损伤后勃起障碍组与神经损伤后射精障碍组患者中阴茎定量感觉检测技术的检出率均高于神经诱发电位。结论（1）阴茎定量温度觉检测技术是评价阴部神经特别是传导痛温觉的小神经（C类）纤维结构和功能的有效方法。较之于传统的神经电生理检查，它能够更有效地检测出阴部小神经损伤或功能障碍，可以应用于性功能障碍的临床检测。（2）阴茎定量振动觉技术是评价阴部神经特别是传导触压觉的神经（Aβ类）纤维结构和功能的有效方法。较之于传统的神经电生理检查，它能够更精确地检测出阴茎局部神经损伤或功能障碍，可以应用于性功能障碍的临床检测。%Objective To explore the quantitative sensory testing technology of penis (including temperature and vibration) in male sexual dysfunction (including erectile dysfunction and ejaculatory dysfunction) application value in forensic medicine.Methods Using the TSA-II quantitative sensory analyzer, the heat thresholds, heat pain threshold, and vibration threshold of the glans penis and left hand index finger were detected with limit method in normal control subjects (25 cases), erectile dysfunction patients(50 cases) after nerve injury, anejaculation patients (15 cases) after nerve injury, and simultaneously calculate the glans penis relative sensory threshold, namely the glans penis ratio different sensory threshold respectively with the left hand index finger sensory threshold. at the same time detect the nerve evoked potential. Analysis and comparison of t test application independent sample group.Results In patients with erectile dysfunction group after nerve injury,glans penis sensory threshold was significantly higher than that in the normal control group, heat threshold, heat pain threshold and the relative threshold,there was significant difference between the two groups (P<0.05); vibration threshold and relative threshold was significantly higher than that in the normal control group, there was significant difference between the two groups (P<0.05). In patients with anejaculation after nerve injury, glans penis sensory threshold was significantly higher than that in the normal control group, heat threshold, heat pain threshold and the relative threshold was significantly higher than that in the normal control group, there was significant difference between the two groups (P<0.05); vibration threshold and relative threshold was significantly higher than that in the normal control group, there was significant difference between the two groups(P<0.05).Conclusion (1) the penis quantitative temperature testing technology is the evaluation of pudendal nerve especially small nerve conduction of nociceptive (class C) the effective methods of fiber structure and function. Compared with the traditional neural electrophysiological examination, it can more effectively detect pudendal nerve injury or dysfunction, and can be used in clinical evaluation on sexual dysfunction. (2)The quantitative vibration perception technology is the evaluation of the penis of pudendal nerve especially conductive touch pressure sensation nerve (Aβ) effective method of fiber structure and function. Compared with the traditional neural electrophysiological examination, it can more accurately detect the penis nerve injury or dysfunction, and can be used in clinical evaluation on sexual dysfunction.
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