慢性骨盆疼痛综合征的诊治

The diagnosis and treatment of chronic pelvic pain syndrome

目的 探讨慢性骨盆疼痛综合征 (CPPS)的诊断和治疗。方法 按照NIH分类标准 ,采用PPMT法 ,结合EPS涂片检测和培养结果 ,共筛选出 6 9例患者 ,其中炎症性CPPS(Ⅲa) 15例 ,非炎症性CPPS(Ⅲb) 5 4例。Ⅲa类患者口服广谱抗生素 8周 ,Ⅲb类患者先后或同时应用抗抑郁药、肌肉松弛剂、a受体阻滞剂和镇痛剂 ,同时配合前列腺按摩、中药调理和热水坐浴等综合治疗 12周。结果 前列腺液培养 4 8次 ,支原体感染 5例 ,衣原体感染 3例。治疗 6周前后CPSI症状评分 ,显效 17例 ,有效 4 6例 ,6例无效。31例患者停止治疗 2周 ,16例复发 ;停止治疗 4周 ,2 7例复发 ;停止治疗 6周 ,31例全部复发。结论 综合治疗和治疗个体化对慢性骨盆疼痛综合征有较好疗效 ;

Objective To study the diagnosis and treatment of chronic pelvic pain syndrome. Methods Based on National Institute Health(NIH) classification, 69 cases of CPPS were surveyed, 15 cases being type Ⅲa and 54 type Ⅲb. In addition, chronic prostatitis symptom index (CPSI) of each patient was evaluated. Ⅲa group received broad spectum anxibiotics for 8 weeks, while Ⅲb group received antidepressives, muscle relaxants, analgetics, alpha blockade, combined with thermotherapy and prostatic massage for 12 weeks. Results All the 69 cases were followed up for 12 weeks, from the result of CPSI before and after 6 weeks of treatment, the symptom of 17 patients was significant and that of 47 patients improved, 6 patients felt a better or unchanged. All of the 31 cases in which therapy was withdrawn recurred after 6 weeks. Conclusion Combined treatment and individualized therapy are effective to CPPS, long-term therapy should be administered to prevent recurrence.