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基层医疗环境中勃起功能障碍的诊断与管理

Diagnosis and management of erectile dysfunction in the primary care setting.

作者信息

Rosenberg M T

机构信息

Mid-Michigan Health Centers, Jackson, MI 49201, USA.

出版信息

Int J Clin Pract. 2007 Jul;61(7):1198-208. doi: 10.1111/j.1742-1241.2007.01418.x.

Abstract

Recent advances in the management of erectile dysfunction (ED) involve the use of oral phosphodiesterase type-5 (PDE-5) inhibitor therapies which have transformed the perception of ED for both the patient and the healthcare provider. Recent treatment guidelines, including the American Urological Association (AUA) 2005 guidelines, promote a goal-oriented approach to therapy and emphasise that PDE-5 therapy should be offered to patients with ED as a first-line treatment option, unless contraindicated. Evidence-based studies have identified an association between ED and the presence of risk factors for cardiovascular and other vascular diseases, implicating ED as a marker for other vascular conditions. Therefore, the importance of screening and diagnosis in the primary care setting is paramount in the diagnosis and management of ED-associated comorbidities. This review provides an update on ED screening and management focusing on the use of PDE-5 inhibitor therapy in the primary care setting and also discusses clinical efficacy parameters with regard to recent results from clinical trials.

摘要

勃起功能障碍(ED)管理方面的最新进展包括使用口服5型磷酸二酯酶(PDE-5)抑制剂疗法,这改变了患者和医疗服务提供者对ED的认知。最近的治疗指南,包括美国泌尿外科学会(AUA)2005年指南,提倡采用以目标为导向的治疗方法,并强调对于ED患者,除非有禁忌证,PDE-5疗法应作为一线治疗选择提供给他们。基于证据的研究已确定ED与心血管及其他血管疾病危险因素的存在之间存在关联,这意味着ED是其他血管疾病的一个标志。因此,在初级保健环境中进行筛查和诊断对于ED相关合并症的诊断和管理至关重要。本综述提供了关于ED筛查和管理的最新情况,重点关注在初级保健环境中使用PDE-5抑制剂疗法,并讨论了关于近期临床试验结果的临床疗效参数。

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