中华皮肤科杂志 ›› 2022, Vol. 55 ›› Issue (6): 528-531.doi: 10.35541/cjd.20210278

• 研究报道 • 上一篇    下一篇

男性阴茎附属腺和皮肤淋球菌感染皮损的高频超声研究

范文葛1    张青松2    叶迅3    魏梅1    范志江4    张静1    王玲1    薛峤1    陶晓瑜1    丁浩1    赵军1   

  1. 1苏州大学附属常熟医院  常熟市第一人民医院皮肤科，常熟  215500；2常熟市中医院皮肤科，常熟  215500；3苏州大学附属常熟医院  常熟市第一人民医院影像科，常熟  215500；4苏州大学附属常熟医院  常熟市第一人民医院泌尿外科，常熟  215500
  • 收稿日期:2021-04-06 修回日期:2021-08-06 发布日期:2022-06-02
  • 通讯作者: 范文葛 E-mail:fwgqh@sina.com

Gonococcal infections of the penile skin and accessory glands in men: high?frequency ultrasound features and their clinical significance

Fan Wenge1, Zhang Qingsong2, Ye Xun3, Wei Mei1, Fan Zhijiang4, Zhang Jing1, Wang Ling1, Xue Qiao1, Tao Xiaoyu1, Ding Hao1, Zhao Jun1   

  1. 1Department of Dermatology, Changshu No.1 People′s Hospital, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China; 2Department of Dermatology, Changshu Hospital of Traditional Chinese Medicine, Changshu 215500, Jiangsu, China; 3Department of Radiology, Changshu No.1 People′s Hospital, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China; 4Department of Urological Surgery, Changshu No.1 People′s Hospital, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China
  • Received:2021-04-06 Revised:2021-08-06 Published:2022-06-02
  • Contact: Fan Wenge E-mail:fwgqh@sina.com

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摘要： 【摘要】 目的 了解男性阴茎皮肤和附属腺淋球菌感染皮损的超声影像学表现及其临床意义。方法 2014年1月至2021年1月在常熟市第一人民医院皮肤科纳入经实验室检查确诊且既往未接受过相关治疗的男性阴茎皮肤和附属腺淋球菌感染患者。使用SIEMENS ACUSON X300实时超声显像仪检测阴茎体表淋球菌感染皮损，探头频率7.5 ~ 15 MHz。高频超声影像表现为管状液性暗区者仅予头孢曲松1 g单剂肌内注射；椭圆形液性暗区者，切开引流同时予头孢曲松1 g肌内注射，每天1次，共5 d；低回声区、混合回声区者予头孢曲松1 g肌内注射，每天1次，共5 d，治疗后1个月结节仍不消退者，局部切除结节。治疗后1个月复诊并观察疗效。结果 共收集32例男性阴茎皮肤和附属腺淋球菌感染患者，年龄（28.54 ± 3.27）岁，均有非婚性接触史，非婚性接触至症状出现时间为（4.45 ± 1.03） d，病程（8.64 ± 1.87） d。皮损均单发，位于尿道外口16例（50.00%），龟头7例（21.88%），包皮系带旁5例（15.62%），阴茎缝4例（12.50%）。皮损表现：窦道样损害16例（50.00%），脓肿9例（28.13%），结节7例（21.87%），皮损处均有触痛。高频超声检查：16例（50.00%）表现为管状液性暗区，7例（21.88%）为椭圆形液性暗区，5例（15.62%）为低回声区，4例（12.50%）为混合回声区。16例（50.00%）淋球菌感染累及尿道海绵体，5例（15.62%）累及阴茎海绵体，11例（34.38%）累及阴茎皮下。经治疗，32例均痊愈。结论 高频超声可用于男性阴茎皮肤和附属腺淋球菌感染患者的皮损评估和治疗方案的选择。

关键词: 淋病, 淋病奈瑟球菌, 附属腺, 高频超声

Abstract: 【Abstract】 Objective To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance. Methods From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone （1 g）; those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. After 1-month treatment, the patients were followed up, and the efficacy was evaluated. Results A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases （50.00%）, at the glans of penis in 7 cases （21.88%）, beside the foreskin frenulum in 5 cases （15.62%）, as well as at the penile raphe in 4 cases （12.50%）. Sixteen patients （50.00%） presented with sinus-like lesions, 9 （28.13%） with abscesses, 7 （21.87%） with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases （50.00%）, oval-shaped anechoic fluid-filled areas in 7 cases （21.88%）, hypoechoic areas in 5 cases （15.62%）, and mixed echoic areas in 4 cases （12.50%）. Gonococcal infections involved the cavernous body of urethra in 16 cases （50.00%）, cavernous body of penis in 5 cases （15.62%）, and subcutaneous penis in 11 cases （34.38%）. After treatment, all patients were cured. Conclusion High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

Key words: Gonorrhea, Neisseria gonorrhoeae, Accessory gland, High-frequency ultrasound