Ⅲ型前列腺炎与间质性膀胱炎鉴别的临床研究  

Clinical Differential Diagnosis of Type Ⅲ Prostatitis and Interstitial Cystitis

作　　者：刘铁军[1] 赵盟杰[1] 沙可夫[1] 高居忠[1] 

机构地区：[1]北京康复中心,北京市西山医院神经泌尿外科,北京100144

出　　处：《中华男科学杂志》2009年第2期140-143,共4页National Journal of Andrology

摘　　要：目的:探讨Ⅲ型前列腺炎与间质性膀胱炎的鉴别诊断,从而提高该类疾病的诊治效率。方法:通过4例Ⅲ型前列腺炎和3例间质性膀胱炎临床病例的总结,从临床症状学、尿流动力学、前列腺按摩液(EPS)镜检、微生物学以及治疗等方面描述两种疾病的特征。结果:Ⅲ型前列腺炎与间质性膀胱炎的共同临床特征是均以下腹部及盆底的不适、疼痛为特点,但间质性膀胱炎患者具有随着储尿时间的延长下腹部疼痛逐渐加重,排尿后明显缓解,膀胱容量明显减少,EPS无异常,微生物培养阴性,行为治疗、辣椒素类似物、透明质酸钠及麻醉下膀胱水扩张阳性且治疗有效。Ⅲ型前列腺炎的EPS镜检时WBC升高或正常、微生物培养阴性,以上针对间质性膀胱炎的治疗对其无效。结论:Ⅲ型前列腺炎与间质性膀胱炎是临床上容易混淆的两种疾病,但由于它们的发病原因尤其是发病部位的不同,使得它们具有各自不同的特征,全面检查后还是可以鉴别的。Objective： To investigate the differential diagnosis of type Ⅲ prostatitis and interstitial cystitis so as to improve the efficiency of diagnosis and treatment of the two diseases. Methods ： Based on the clinical data of 4 cases of type Ⅲ prostatitis and 3 eases of interstitial cystitis, we analyzed the characteristics of the two diseases in such aspects as clinical symptomatology, urodynamics, prostatic fluid microscopy, microbiology and treatment. Results： The common clinical characteristics of type Ⅲ prostatitis and interstitial cystitis were indisposition or pain in the subabdomeu and/or pelvic floor, but their differences were quite obvious. In interstitial cystitis, longer urine accumulation could cause worse pain in the subabdomen, which could be relieved after micturation, and the bladder capacity was obviously decreased, but with normal prostatic fluid and negative result of microbial culture. It responded to behavior therapy, resiniferatoxin, sodium hyaluronate and water dilation of the bladder under anaesthesia. While type Ⅲ prostatitis, with white blood cells 〉 10/HP or ≤ 10/HP in the prostatic fluid and negative result of microbial culture, did not respond to the above therapeutic methods that were effective for interstitial cystitis. Conclusion ： Type Ⅲ prostatitis and interstitial cystitis, although clinically confusable, can be definitely differentiated from each other according to their characteristic causes and locations.

关 键 词：Ⅲ型前列腺炎 间质性膀胱炎 

分 类 号：R694.3[医药卫生—泌尿科学] R697.3[医药卫生—外科学]