非特异性肉芽肿性前列腺炎的诊治体会(附32例报告)  

Diagnosis and Treatment of Non-specific Granulomatous Prostatitis:A Report of 32 Cases

作　　者：范海涛[1] 王凯臣[2] 张慕淳[2] 王伟华[2] 计国义[2] 王尧[2] 孔祥波[2] 

机构地区：[1]吉林大学第二医院泌尿外科,吉林长春130041 [2]吉林大学中日联谊医院泌尿外科暨吉林大学前列腺疾病防治研究中心,吉林长春130033

出　　处：《中华男科学杂志》2008年第2期131-134,共4页National Journal of Andrology

基　　金：中日政府间专项技术合作项目第59项(JICA援助项目)

摘　　要：目的:探讨非特异性肉芽肿性前列腺炎(NSGP)的诊断和治疗方法。方法:2000年9月～2006年5月共诊治NSGP32例,均采用经直肠超声(TRUS)引导下穿刺活检病理确认后,给予抗生素等药物治疗。结果:NSGP的基本病理形态特征是以导管或腺泡为中心的肉芽肿。32例随访6～48个月,平均24个月。排尿刺激症状及梗阻症状好转,Qmax提高至15.0～24.0ml/s,3例尿潴留患者经治疗后,Qmax分别为12.0、14.5和16.5ml/s。直肠指检前列腺硬结缩小至0.5cm×1.0cm左右,质地变软,但恢复较慢,可达12个月。血PSA降至1.3～11.5μg/L,其中17例<4μg/L。4例于治疗后6～12个月症状复发,血PSA上升,经再次抗炎治疗,症状缓解,2例PSA<4μg/L;2例PSA仍>4μg/L,但未发现PCa。结论:TRUS引导下穿刺活检是确诊NSGP的方法;抗生素加用α受体阻断剂可明显缓解症状;对于梗阻症状严重,合并尿潴留患者可行经尿道电切术。Objective： To discuss the diagnosis and treatment of non-specific granulomatous prostatitis （NSGP）. Methods ： Thirty-two cases of NSGP were diagnosed by puncture biopsy under transrectal ultrasound （TRUS） and treated with antibiotics and other medicines from September, 2000 to May, 2006. Results ： Pathomorphologically, NSGP was basically characterized by granuloma with vessels or grand alveoli in the center. The mean follow-up was 24 months. Urination irritation and obstruction were improved. Qmax was increased to 15.0-24.0 ml/s, and in 3 cases of urinary retention, to 12.0, 14.5 and 16.5 ml/s, respectively. Digital rectal examination （DRE） indicated a reduced size and softened texture of the prostate induration. PSA was decreased to 1.3-11.5μg/L. Four cases experienced relapse but were cured after retreated. No prostate cancer was observed. Conclusion ： NSGP can be definitely diagnosed by puncture biopsy under TRUS and effectively relieved by antibiotics with the or-receptor blocker, in case of serious obstruction complicated by urinary retention, transurethral electrotomy can be considered. NatlJAndrol, 2008, 14（2） ： 131-134

关 键 词：前列腺炎 肉芽肿 病理诊断 经直肠超声 

分 类 号：R697.3[医药卫生—泌尿科学]