CO_2激光治疗慢性前列腺炎的安全性和有效性初步观察

Observation on safety and efficacy of CO_2 laser equipment on chronic prostatitis

目的观察CO2激光器对于治疗慢性前列腺炎的疗效和安全性。方法患者112例,分为激光治疗组和药物综合治疗对照组各56例。确诊为慢性非细菌性前列腺炎ⅢA和ⅢB类。激光治疗组:经尿道插入并定位于前列腺部。照射能量18J/次,隔天治疗1次,每周2次。根据美国国立卫生院慢性前列腺炎症状评分表(NIH2CPSI)进行治疗前后的疗效判断。结果症状程度评分值较治疗前减少60%1以上为改善。疼痛和不适改善率83.9%,排尿次数的改善率69.6%,对工作以及对心理的影响改善率71.4%(40/56),生活质量评分改善率73.2%(P<0.05);治疗前后前列腺按摩液(EPS)中WBC的数量改善不明显(P>0.05);治疗过程中未发生不良事件(如排尿不适、血尿、持续的尿路感染等)。结论用CO2激光器进行慢性前列腺炎的治疗是安全而有效的。

[Objective] To estimate the safety and efficacy of a new developed CO2 laser equipment on chronic prostatitis. [Methods ] 112 male patients suffering chronic prostatitis were enrolled and randomized into laser treated group and control group （56 patients each）. In our study the diagnosis was established by Mears2Stamey test and the enrolled patients were classified as Type ⅢA ＆ Ⅲ B according to National Institutes of Health Chronic Prostatitis Symptom Index （NIH2CPSI）. Laser irradiation was performed after inserting and locating an optic fiber into the prostatic urethra, and the patients received treatment twice a week. [Results] The efficacy estimation was also based upon the National Institutes of Health chronic prostatitis symptom index. In the study, treatment improvement was nominated only when the quantitive index decreasing reached 60% or more. The improvement on genitourinary or rectal pain was 83.9%, on voiding symptoms was 69.6%, while for influence on work and mental health was 71.4%, and the improvement of symptoms＇ influence on life quality was 73.2% （all P 〈0.05）. No significant change of EPS＇s WBC count was found after the treatment （P 〉0.05）. No adverse effects including mixturation pain, hematuria, urinary infection, etc. were found in the study. [Conclusion] CO2 laser treatment is an effective and safe alternative for relieving the symptoms of chronic prostatitis.