自我隐瞒水平对高强度聚焦超声治疗难治性慢性前列腺炎患者生命质量及临床疗效的影响

The influence of self-concealment level on patients＇ quality of life and clinical curative effect for curing refractory chronic prostatitis by high-intensity focused ultrasound

目的探讨自我隐瞒水平对高强度聚焦超声（High Intensity Focused Ultrasound，HIFU）治疗难治性慢性前列腺炎患者生命质量及临床疗效的影响。方法对符合诊断标准的难治性慢性前列腺炎（Refractory Chronic Prostatitis，RCP）患者，进行自我隐瞒量表（Self-Concealment Scale，SCS）、TDL生命质量测定表（TDL＇s Table of Self-Assessing Quality of Life）、慢性前列腺炎症状指数评分（Chronic Prostatitis Symptom Index，CPSI）测评，以SCS的总分高于被试在该量表得分平均数加上一个标准差作为高自我隐瞒组，低于平均数减一个标准差作为低自我隐瞒组。研究2组患者高强度聚焦超声治疗前后CPSI、TDL生命质量测定表评分的变化，并对比临床疗效的差异。结果RCP患者SCS入组时评分为（35．75±10．34）分，显著高于男性大学生常模的（29．20±8．73）分（t=4．26，P〈0．01）。HIFU治疗2周、6周后低自我隐瞒组CPSI评分降低显著，与高自我隐瞒组比较差异有显著性（P〈0．01）；高自我隐瞒组、低自我隐瞒组治疗2周、6周后，分别与入组时比较，CPSI评分显著降低（P〈0．01）。低自我隐瞒组TDL生命质量测定表评分，入组时及HIFU治疗2周、6周后均高于高自我隐瞒组（P〈0．01）。低自我隐瞒组治疗2周、6周后，与入组时比较，TDL生命质量测定表评分显著增高（P〈0．01）；而高自我隐瞒组至HIFU治疗6周后，TDL生命质量测定表评分才显著高于入组时（P〈0．05）。低自我隐瞒组HIFU治疗6周后，其临床疗效显著好于高自我隐瞒组（P〈0．05）自我隐瞒评分与CPSI评分呈显著正相关（P〈0．01），而与TDL生命质量测定表评分呈显著负相关（P〈0．01）。结论难治性慢性前列腺炎患者自我隐瞒水平高者，其HIFU治疗后症状改善、生活质量、临床疗效均较自我隐瞒水平低者差。

Objective To explore the influence of self-concealment level on patients ＇ quality of life and clinical curative effect for curing refractory chronic prostatitis （RCP） by high-intensity focused uhrasound （HIFU）. Methods Patients of RCP who meet the diagnostic criteria were assessed with the Self-Concealment Scale （SCS） , TDL＇ s table of self-assessing quality of life and National Institutes of Health-Chronic Prostatitis Symptom Index （NIH-CPSI）. The patients whose SCS score were above the average score plus a standard deviation were taken as the high SCS group,and whose SCS score were below the average score minus a standard deviation were taken as the low SCS group. The scores for CPSI and TDL＇s table of self-assessing quality of life and the clinical curative effect of the two groups were determined before and after the treatment by HIFU, respectively. Results The SCS score （35.75 ± 10.34） of the RCP patients before HIFU treatment was significantly higher than the norm for male college students（29.20 ±8.73）（t = 4.26, P〈0.01 ）. Two and six weeks alter the HIFU application,the CPSI of both the high and the low SCS group decreased significantly （P 〈 0.01 ） , and the CPSI of the low SCS group decreased more greatly than that of the high SCS group （P 〈 0.01 ）. The scores for TDL Life Quality Scale of low SCS group were significantly higher before and after two and six weeks＇ HIFU treatment than that of high self-concealment group（P〈 0. 01）. The TDL quality of life scale score of the low SCS group increased respectively after two and six weeks＇ HIFU treatment （ P 〈 0.01 ） , while for the high SCS group, this score increased only after six weeks＇ HIFU treatment （P 〈 0.05 ）. Six weeks after HIFU treatment, the clinical curative effect for the low SCS group was observably better than that for high self-concealment （P 〈 0.05 ）. The SCS scores was significantly positive with CPSI scores（P 〈 0.01 ） , and significantly negative with the scores of TDL Life Quality Scale （P 〈 0.01 ）. Conclusion The symptom abatement,quality of life and clinical curative effect for the RCP patients with a high serf-concealment level were respectively worse after the HIFU treatment than that for whom with a low self-concealment level.