小剂量短疗程糖皮质激素治疗急性细菌性睾丸-附睾炎临床疗效对比

Therapeutic effect analysis of low dose and short course of glucocorticoid in the treatment of acute bacterial epididymal orchitis

目的分析并探讨敏感抗生素结合小剂量短疗程糖皮质激素治疗急性细菌性睾丸-附睾炎的临床疗效。方法回顾性分析175例2010年1月~2018年5月在我院及云南省第三人民医院接受治疗的、明确诊断为急性细菌性睾丸-附睾炎患者,其中单纯抗生素治疗组(简称:单纯治疗组)38例和抗生素结合糖皮质激素治疗组(简称:联合治疗组)137例。两组均使用氨基糖甙类抗生素+二代头孢类或喹诺酮类抗生素双联抗生素抗感染治疗。抗生素结合糖皮质激素治疗组联合使用地塞米松针2~3mg静脉用药2~3天。结果单纯治疗组和联合治疗组患者治疗后第1天和第2天疼痛强度评分与治疗前评分差值的比较分别为[(1.3±0.6)vs(3.5±0.7)]和[(2.3±0.8)vs(4.6±1.4)],差异均具统计学意义(P<0.05),住院时间[(10.7±3.6)d vs(5.6±1.7)d]、住院消耗费用[(6423±2522)元vs(4631±1275)元]和3天疾病进展率[13.1%(5/38)vs 0.7%(1/137)]比较,差异也均具有统计学意义(P<0.05)。未见明显糖皮质激素相关副作用。结论敏感抗生素结合小剂量短疗程糖皮质激素治疗急性睾丸-附睾炎,能够有效提升睾丸-附睾炎治疗效果,明显改善症状,缩短治疗时间,未见明显糖皮质激素相关副作用。

Objective To analyze the clinical therapeutic effect of sensitive antibiotics combined with low dose and short course of glucocorticoid in the treatment of acute bacterial epididymal orchitis.Methods Clinical data of 175 patients with acute bacterial epididymal orchitis who were treated in our hospital and the third hospital of Yunnan province from January 2010 to May 2018 were retrospectively analyzed.The patients were divided into two groups including antibiotics alone group(38 cases)and antibiotics combined with glucocorticoid group(137 cases).The patients in both groups were treated with aminoglycoside antibiotics+second generation cephalosporin antibiotics or quinolone antibiotics.The patients in antibiotics combined with glucocorticoid group were simultaneously given with 2-3 mg dexamethasone intravenously for 2-3 days.Results The decrease score about the pain intensity in two groups after 1 day and 2 days treatment were[(1.3±0.6)vs(3.5±0.7)]and[(2.3±0.8)vs(4.6±1.4)].Average hospitalization times of two groups were(10.7±3.6)days vs(5.6±1.7)days.Average medical expenditure were(6423±2522)yuan vs(4631±1275)yuan.Disease progression rate after 3 days treatment were[13.1%(5/38)vs 0.7%(1/137)].These parameters above in antibiotics combined with glucocorticoid group were all better than those of the antibiotics alone group(P<0.05).Glucocorticoid-related side effects were rarely observed.Conclusion Sensitive antibiotics combined with low doses and short course of glucocorticoid can significantly improve the therapeutic outcome of the patients with epididymal orchitis.Obvious glucocorticoid-related side effects rarely occurred.