湖南地区泌尿男科医生对慢性前列腺炎诊治行为的调查

A survey of urologist’s and andrologist’s diagnostic and treatment practices for chronic prostatitis in Hunan Area

目的了解湖南地区泌尿男科医师对慢性前列腺炎（CP）诊治的现状。方法在湖南省男科学会成立的学术会议上，对12l位湖南地区泌尿男科医师进行问卷调查，收回有效问卷92份进行分析。结果在CP的病因上，87％的医师认为感染因素是最主要的因素，其中39％则认为感染是唯一因素，其余的则认为是多个因素引起的。在诊断方面，不同的医生采用不同的诊断策略。只有45％的医生选用细菌培养，其中85％选择前列腺液单纯培养、4％选择精液培养、9％两杯法培养、2％四杯法培养。在治疗上，94％的医师选择多种方法综合治疗。93％的医师必定选用抗生素，使用抗生素前3位的是大环内酯类、喹诺酮类、头孢类，多数医师使用2-3周。6l％的医师会使用α-受体阻滞剂，大多数使用2-3周。6l％的医师评估自己治疗效果很好或较好。结论泌尿男科医师对CP的病因及发病机理仍没有统一的认识，对该病的诊断和治疗有各自不同的选择。因此，制定一个合理的诊治指南并进行有关的培训是非常必要的。

Objective To investigate present status of urologist＇s and andrologist＇s diagnostic and treatment practices for chronic prostatitis （CP） in Hunan area. Methods A self-administrated questionnaire about doctor＇s diagnostic and treatment practices for chronic prostatitis was carried out in 121 urologists and andrologists Hunan province and data from 92 valid questionnaire were analyzed. Results For the etiology of chronic prostatitis, 87% of doctors considered the infection as the primary risk factor which was considered as the only causative agent by 39% of them, the rest thought multiple factors as the etiology. In the diagnosis, different doctors had their own diagnostic strategy. 45% of doctors routinely did bacterial culture in which cultures of single prostatitic secretion, semen, two-glass test and four-glass test were used by 85%, 4%, 9% and 2% of the doctors respectively. In the treatment, combined therapies were done by 94% of the doctors. Antibiotic treatment was chosed by 93% of the them. The leading antibiotics used were macrolides, quinolones and cephalosporins, which was used for 2-3 weeks by majority of the doctors, α-receptor blocking agent was used by 61% of the doctors and it would be used for 2-3 weeks by most of them. The majority considered the therapy as efficacious, however, their assessment method was different. Conclusion There are not unified consensus on the etiology and pathogenesis of CP for urologists and andrologicsts, and wide variations in their diagnostic and treatment practices for it. It is necessary to make a rational guideline and to carry out pertinent training to the doctors for the management for CP.