青春期慢性前列腺炎及其盆底肌生物反馈治疗  

Chronic prostatitis during puberty and the effects of pelvic floor biofeedback therapy

作　　者：李源[1] 齐琳[1] 文建国[2] 祖雄兵[1] 陈智勇[1] 

机构地区：[1]中南大学湘雅医院泌尿外科,长沙410008 [2]郑州大学第一附属医院小儿泌尿外科和尿动力学中心

出　　处：《中华泌尿外科杂志》2006年第12期854-857,共4页Chinese Journal of Urology

基　　金：国家自然科学基金资助项目(30571931);河南省高等学校创新人才培养工程资助项目(2002-2007)

摘　　要：目的探讨青春期慢性前列腺炎(CPP)的临床特点及盆底肌生物反馈治疗疗效。方法CPP患者25例,平均年龄16岁。下尿路相对正常研究对象15例作为对照组,平均年龄16岁。CPP患者组行慢性前列腺炎症状(NIH-CPSI)评分,前列腺按摩液(EPS)常规检查、细菌培养,行NIH分型。40例均行尿动力学检查,分析尿流曲线,记录最大尿流率(Q_(max))、剩余尿量(PVR)、逼尿肌括约肌协同失调(DSD)、最大逼尿肌排尿压(P_(det.max))、最大尿道闭合压(MUCP)等参数。CPP患者行生物反馈治疗,10周后评估疗效。结果CPP组中Ⅱ、ⅢA和ⅢB型分别为1、3和21例。治疗前CPP组和对照组Staccato排尿(20例vs．1例)和DSD (22例vs．1例)、Q_(max)(10．7±3．7 ml/s vs．15．0±4．3ml/s)、PVR(7．7±4．1 ml vs．3．2±2．6 ml)、P_(det.max)(115．1±33．6 cm H_2O vs．76．8±16．6 cm H_2O)和MUCP(176．5±45．7 cm H_2O vs．86．2±28．5 cm H_2O)比较差异有统计学意义(P＜0．05)。CPP组患者生物反馈治疗前后NIH-CPSI疼痛评分(4．6±2．2 vs．2．1±1．6)、排尿评分(7．9±2．0 vs．2．2±1．7)、生活影响评分(9．4±2．2 vs．2．6±2．1)、总分(22．0±5．2 vs．7．0±4．2)和Q_(max)(10．7±3．7 vs．14．9±5．6)差异有统计学意义(P＜0．05)。结论CPP以ⅢB型多见,临床主要表现为排尿异常,患者精神压力较大,有盆底肌功能障碍和尿动力学异常表现,盆底肌生物反馈治疗的近期疗效满意。Objective To investigate the features of chronic prostatitis during puberty （CPP） and the effects of pelvic floor biofeedback therapy. Methods Totally,25 CPP children （mean age, 16 years） and 15 children （mean age, 16 years） with normal lower urinary tract as controls were included. In CPP group, NIH-CPSI scores were evaluated, expressed prostatic secretions （EPS） were examined,and bacterial culture was done;and CPP patients were categorized based on the definitions of NIH types. In both groups, urodynamic examination was performed, including evaluation of uroflow curve, maximum flow rate （ Qmax ） , post-voiding residual urine （PVR） , detrusor-sphinctcr dyssynergia （ DSD ）, maximum detrusor pressure （Pdet.max ） and maximum urethral closure pressure （MUCP）. CPP patients underwent biofeedback therapy, and 10 weeks later the effects were assessed. Results In CPP group,NIH typing showed Ⅱ , Ⅲ A and Ⅲ B in 1,3 and 21 cases, respectively. Before treatment in CPP and control groups, the incidence of staccato voiding （20 cases vs 1 case）,DSD （22 cases vs 1 case）, Qmax（10.7±3.7 vs 15.0±4.3 ml/s）, PVR （7.7±4.1 vs3.2±2.6 ml）, Pdet.max （115.1±33.6 vs76.8±16.6 cm H2O） and MUCP （176.5±45.7 vs 86.2±28.5 cm H2O） all showed significant differences between the 2 groups （P 〈 0. 05）, In CPP group,the differences in pain （4.6±2.2 vs 2. 1±1.6） ,urination （7.9± 2.0 vs 2.2±1.7） ,life impact （9.4±2.2 vs2.6±2.1） and total scores （22.0±5.2 vs7.0±4.2） of NIH-CPSI and Qmax（10.7±3.7 vs 14.9±5.6） between pre- and post-biofeedback were significant （P 〈0.05）. Conclusions The main type of CPP is category ⅢB. The primary symptom is voiding disorder,which leads to greater psychological stress in patients. Children with CPP have pelvic floor dysfunctions and multiple abnormal urodynamic parameters. The short-term effect of biofeedback strategies for CPP is satisfactory.

关 键 词：慢性前列腺炎 青春期 尿动力学 生物反馈 

分 类 号：R697.3[医药卫生—泌尿科学]