经会阴超声治疗慢性Ⅲ型前列腺炎的临床效果

CLINICAL EFFECT OF TRANSPERINEAL ULTRASOUND IN THE TREATMENT OF CHRONIC TYPE Ⅲ PROSTATITIS

目的通过与传统药物治疗比较,探讨经会阴超声治疗慢性Ⅲ型前列腺炎的效果。方法收集就诊于青岛大学附属医院泌尿男科门诊、符合慢性前列腺炎(Ⅲ型)诊断标准的174例病人,随机分为超声组和药物组。超声组采用经会阴超声治疗,每次治疗总时间为45 min,隔1~2 d治疗1次;药物组给予左氧氟沙星联合盐酸坦索罗辛治疗。疗程均为2周。比较两组病人治疗前后的国际前列腺症状评分表(IPSS)评分、美国国立卫生研究院慢性前列腺炎症状评分表(NIH-CPSI)评分、前列腺液检查指标(白细胞、卵磷脂小体),依据NIH-CPSI评分疗效评价标准评价两组疗效,并记录不良反应。结果与治疗前相比,两组病人治疗后IPSS、NIH-CPSI评分及前列腺液检查指标均出现不同程度的改善,差异有显著性(t=2.26~10.04,P<0.05);两组间相比,超声组IPSS评分、NIH-CPSI评分及其疼痛症状评分、症状影响评分、生活质量评分的改善均优于药物组,差异有统计学意义(t=4.54~15.23,P<0.01),而排尿症状评分、前列腺液指标差异无统计学意义(P>0.05)。超声组和药物组治疗总有效率分别为75.86%和49.43%,两组疗效比较差异有统计学意义(H=5.77,P<0.01)。所有病人治疗后均未出现不良反应。结论与传统的药物治疗相比,经会阴超声治疗慢性Ⅲ型前列腺炎在临床疗效、相关症状评分等方面具有良好改善作用,无明显不良反应,值得临床推广应用。

Objective To investigate the clinical effect of transperineal ultrasound versus conventional medication in the treatment of chronic typeⅢprostatitis.Methods A total of 174 patients who met the diagnostic criteria for chronic prostatitis(typeⅢ)and were treated in the outpatient service of Department of Urology and Andrology,The Affiliated Hospital of Qingdao University,were enrolled and randomly divided into ultrasound group and drug group.The patients in the ultrasound group were treated with transperineal ultrasound for 45 minutes,once every one or two days,and those in the drug group were treated with levofloxacin combined with tamsulosin hydrochloride.The course of treatment was 2 weeks for both groups.The two groups were compared in terms of International Prostate Symptom Score(IPSS),National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI),and prostatic fluid examination(leukocyte and lecithin body)before and after treatment,and the clinical outcome was evaluated based on NIH-CPSI score.Adverse reactions were also recorded.Results Both groups had significant improvements in IPSS score,NIH-CPSI score,and prostatic fluid indices after treatment(t=2.26-10.04,P<0.05),and compared with the drug group after treatment,the ultrasound group had significantly better improvements in IPSS score,NIH-CPSI score,pain score,symptom impact score,and quality of life score(t=4.54-15.23,P<0.01),while there were no significant differences in urination score and prostatic fluid indices between the two groups(P>0.05).There was a significant difference in overall response rate between the ultrasound group and the drug group(75.86%vs 49.43%;H=5.77,P<0.01).No adverse reactions were observed after treatment.Conclusion Compared with conventional medication in the treatment of chronic typeⅢprostatitis,transperineal ultrasound can better improve clinical outcome and related symptom scores,with no adverse reactions,and therefore,it holds promise for clinical application.