淋球菌性前列腺炎的综合护理

淋菌性前列腺炎是继发于淋菌性尿道炎之后,常由于初起治疗不及时、不恰当或感染耐药菌株导致慢性淋菌性前列腺炎。本文对我院收治的40例淋菌性前列腺炎患者在常规抗生素治疗的基础上,采用中药灌肠、前列腺按摩等办法综合护理,能够使患者的临床症状得到缓解,疗效明显,有助于患者康复。     

32例急性淋菌性尿道炎并发慢性淋菌性前列腺炎诊断报告

2003-2004年乌鲁木齐市第一人民医院门诊部发现32例急性淋菌性尿道炎后淋菌性前列腺炎患者,年龄16～35岁,平均22岁.本组患者有明确的不洁性接触史,即急性淋菌性尿道炎病史,主要病状有尿痛,排尿终末尿道口有白色分泌物,呈黄白色,尿道口略发红,尿中有淋丝,腰部发酸及发困,会阴部有出汗及不适感,耻骨上区有间歇性胀痛,病程2～24个月,并且有反复急性发作史,32例均经前列腺液常规及尿道分泌物直接涂片检查,确诊为慢性淋菌性前列腺炎.     

性病引发前腺炎78例临床分析

1996～ 2 0 0 0年 ,我们收治由性病引发的前列腺炎 78例 ,经治疗效果满意。报告如下。一般资料 :本组 78例 ,年龄 2 0～ 5 5岁 ,平均 31.6岁。所有患者都有不洁性接触史和尿道炎史。以往无前列腺炎症状。其中淋病 43例 ,淋病伴支原体、衣原体感染 35例。病史 7～30天。患者感觉会阴部胀痛 ,膀胱区、下腹部及双侧腹股沟、精索部位、睾丸及附睾处疼痛不适。有尿道烧灼感 ,有时尿道口有少量白色分泌物 ,尿频、尿急、排尿不畅等前列腺炎症状。所有患者都行前列腺按摩 ,前列腺液常规涂片检查 ,细菌培养和药敏试验 ,衣原体和支原体检查 ,根据检查…     

慢性前列腺炎的病因、发病机制及治疗

慢性前列腺炎是泌尿外科最常见疾病,发生率约占泌尿外科患者的33％。该病明显影响患者生活质量,其程度与近期心肌梗死、不稳定心绞痛、活动性克隆病相似。随着对该病的深入研究,近年来对其病因、发病机制、诊断及治疗有了新的认识。1 病因 慢性细菌性前列腺炎约占慢性前列腺炎5％,通常由细菌经尿道逆行侵犯前列腺所致,偶因血行感染或急性前列腺炎转归而来,亦有继发于周围组织器官炎症或经淋巴播散所致。致病菌常见为表皮葡萄球菌、微球菌、金黄色葡萄球菌、克雷伯菌、肠杆菌属等。慢性细菌性前列腺炎临床特征为同一病原体引起的反复尿路感染,虽经抗生素治疗,该病原体依然存在于前列腺液中。原因可能与前列腺解剖因素有关即前列腺导管细长弯曲,开口处口径小,与尿道成直角或斜行向上进入     

支原体对4种抗生素的药敏试验结果分析

近年来 ,由于检验技术的提高 ,支原体感染在非淋菌性尿道炎中的检出率越来越高。 2 0 0 3年 2～ 12月 ,我院细菌室检测的 4 36份非淋菌性尿道炎分泌物临床标本中 ,2 4 6份检出支原体 ,包括解脲支原体和人型支原体 ,现将结果报告如下。资料与方法 :2 4 6份标本取自支原体性尿道炎患者。标本采集 :宫颈分泌物 (女性 )和男性分泌物或尿道精液、前列腺液。用无菌专用尿道拭子插入尿道 2～ 4 cm处停留约 1分钟 ,轻轻转动取含柱状上皮细胞的标本 ,精液和前列腺液按常规采取。分别进行氧氟沙星、红霉素、交沙霉素及强力霉素的药理敏感试验。表 1　 …     

EPS中性粒细胞弹性蛋白酶测定在慢性前列腺炎诊断治疗中的意义

目的探讨慢性前列腺炎患者前列腺液（EPS）中中性粒细胞弹性蛋白酶（NE）浓度检测在慢性前列腺炎诊断治疗中的意义。方法对70例慢性前列腺炎患者（观察组）及70例正常对照（对照组）EPS行NE浓度测定、前列腺液常规检查、细菌培养及NIH前列腺炎症状评分（CPSI）。观察组患者治疗4周后,再次进行NE测定、WBC计数、CPSI。结果观察组患者EPS中NE浓度、WBC计数、CPSI间两两比较均呈正相关。NE浓度、CPSI、WBC计数组间比较,P均〈0．05。观察组患者治疗前后NE水平、WBC计数、CPSI比较,P〈0．05。结论测定EPS中NE浓度对慢性前列腺炎的诊断和治疗有一定的指导作用。     

慢性细菌性前列腺炎综合治疗145例体会

前列腺炎包括细菌性前列腺炎和非细菌性前列腺炎 ,是具有独自特性的一种综合征。近年来 ,我院从多方面、多角度综合治疗细菌性前列腺炎 14 5例 ,报告如下。临床资料 :本组 14 5例患者的年龄 18～ 5 3岁 ,平均为 36岁。其中有急性发作病史 12例 ,射精后疼痛并早泄 18例 ,无症状菌尿 15例 ,B超检查合并前列腺结石 6例。患者均有不同程度的尿路刺激症状 ,如尿痛、尿急、尿频及夜尿多 ,会阴、阴囊及尿道内有不适感或疼痛。前列腺按摩液显微镜检查每高倍视野含有 10个以上白细胞。尿液、前列腺按摩液的细菌定量培养 (Stamey四杯法 )有反复发作的…     

淋菌性前列腺炎的诊治

淋菌性前列腺炎的诊治马森宝焦志友张光银刘跃新贺从戎岳春河罗观北京同仁医院（１００７３０）淋菌性尿道炎如果不治疗，或接受了不规范的治疗，治愈标准掌握不明确，急性症状可以消失，尿道中可无淋菌存在，但在尿道球腺、尿道隐窝、前列腺和精囊开口处仍有淋球菌隐伏，...     

药物局部注射治疗慢性细菌性前列腺炎40例报告

1992年以来,我们对40例前列腺液细菌培养阳性的慢性细菌性前列腺炎(CBP)患者,根据其细菌药敏试验结果选择抗生素行局部注射治疗,取得了较为满意的效果。     

1687例前列腺炎患者前列腺液及尿道拭子标本中耐甲氧西林葡萄球菌检测分析

前列腺炎是成年男性的多发病及常见病,近年来抗生素的不规范使用致尿道口耐药菌分离株越来越多。近期,我们对1687例前列腺炎患者前列腺液及尿道拭子标本中的耐甲氧西林葡萄球菌（MRS）进行了检测,旨在为临床治疗提供依据。     

Clinical and microbiological investigation of men with urethritis.

Of 377 men attending clinics for the treatment of sexually transmitted disease, 104 had gonococcal urethritis, 72 had definite nongonococcal urethritis, 53 had possible nongonococcal urethritis, and 123 had no urethritis. A purulent urethral discharge was noted in 78% and 14% of patients with gonococcal urethritis and definite nongonococcal urethritis, respectively (P less than 0.001). In contrast, 4% and 64% of men with gonococcal urethritis and definite nongonococcal urethritis, respectively, had a clear urethral discharge (P less than 0.001). Black men with urethritis were more likely to have gonococcal infection, whereas white men were more likely to have nongonococcal urethritis. Homosexual and bisexual white men with urethritis were more likely to have gonorrhea, whereas heterosexual white men with urethritis were more likely to have nongonococcal urethritis. Heterosexual men were more likely than homosexual men to be colonized with Ureaplasma urealyticum. There were no differences in the rates of colonization with Mycoplasma hominis among heterosexual and homosexual men.     

The effects of antiretroviral therapy on HIV-1 RNA loads in seminal plasma in HIV-positive patients with and without urethritis.

BACKGROUND: High seminal plasma HIV-1 RNA loads (SVL) have been reported during gonococcal, non-gonococcal and chlamydial urethritis in patients not taking antiretroviral therapy. OBJECTIVE: To examine if urethritis leads to increased SVL in HIV-positive patients taking antiretroviral therapy. METHODS: Men who had been taking therapy for at least 3 months were recruited: 24 had urethitis (PWU) and 16 were without urethritis (controls). At three visits, 1 week apart, blood plasma viral load (BVL) and SVL were assayed by quantitative polymerase chain reaction or the NASBA assay. RESULTS: Most subjects had undetectable SVL (18 PWU, 13 controls). Among those with undetectable BVL prior to first study visit, virus was undetectable in semen in 5/5 episodes of chlamydial urethritis, 6/7 episodes of non-gonococcal urethritis and 4/5 cases of gonococcal urethritis. Two PWU with undetectable BVL just prior to the first study visit had low to moderate SVL, which became undetectable by visit 2 following treatment. Of nine subjects with detectable SVL, eight had detectable BVL (3/3 controls and 5/6 PWU). Of these, 1/3 controls and 4/5 PWU (all with gonococcal urethritis) had poorly controlled BVL just prior to the first study visit. These four PWU had high SVL and one had higher levels in semen than in blood. This patient's SVL was reduced more than 20-fold following treatment for gonococcal urethritis. CONCLUSIONS: Effective antiretroviral therapy appeared to limit the effect of urethritis on SVL. When BVL was poorly controlled by antiretroviral therapy, high SVL occurred during gonococcal urethritis, increasing the potential risk of transmitting both wild type and drug resistant strains of HIV-1.     

Sexually transmitted diseases. Urethritis in men

Gonococcal and nongonococcal urethritis (NGU) are among the most common syndromes afflicting men. NGU is caused primarily by Chlamydia trachomatis and Ureaplasma urealyticum, but the cause is unknown in approximately 20 to 30 percent of cases. Evaluation of a gram-stained urethral smear is generally sufficient to distinguish between gonococcal and nongonococcal urethritis. Owing to the frequent coexistence of Neisseria gonorrhoeae and C. trachomatis in heterosexual men, treatment regimens for gonococcal urethritis should generally include an effective antichlamydial regimen. Complications of urethritis are uncommon, but the causative pathogens produce serious morbidity in women. Prevention of urethritis is based on identification of asymptomatically infected persons who serve as the major reservoir of infection with both N. gonorrhoeae and C. trachomatis.     

Successful treatment of uncomplicated gonococcal urethritis in HIV-infected patients with single-dose oral cefpodoxime

Fluoroquinolones are no longer recommended for the treatment of gonococcal infections in the United States. Cephalosporins – ceftriaxone and cefixime – are the treatment of choice, as suggested by the Centers for Disease Control and Prevention (USA). There are limited data on the efficacy of cefpodoxime for the treatment of uncomplicated gonococcal infections. Two cases of HIV-infected homosexual men who were successfully treated with cefpodoxime for urethritis caused by Neisseria gonorrhoeae are described in the present study.     

阿奇霉素治疗急性淋菌性尿道炎效果分析

为了比较阿奇霉素与青霉素治疗急性淋菌性尿道炎的效果,我们首选青霉素治疗100例作为A组,单用阿奇霉素治疗100例作为B组,对其治疗效果进行了分析.结果A组总治愈率为82.2,%B组为95.1%(P<0.05).认为阿奇霉素对治疗淋菌性尿道炎具有效果好、副作用少、服用方便等优点,可作为首选药物.     

Rifampicin-erythromycin combination for the treatment of gonococcal urethritis in men

A total of 184 men with uncomplicated gonococcal urethritis were treated with a single oral dose of rifampicin 900 mg and erythromycin stearate 1 gm. The cure rate on day 3 was 95.1%, 175 were cured and 9 failed (4.9%). Of all the Neisseria gonorrhoeae isolated, 86 were PPNG (46.7%). There was no difference in failure rate among patients with PPNG or with non-PPNG. With the exception of self-limited gastrointestinal disturbance, side effects were minimal. The value of this combination for the treatment of uncomplicated gonococcal urethritis in men is promising and deserves further study.     

A study of Ureaplasma urealyticum pathogenicity in human genitourinary tract]

Ureaplasma urealyticum was investigated in urine from 765 outpatients who visited Jikei University Affiliated Hospital and Tokyo Metropolitan Taito Hospital from June, 1988 to December, 1989 in order to clarify the pathogenicity of U. urealyticum in human genitourinary tract. U. urealyticum in urine was detected by means of Taylor-Robinson's method. The positive rates of U. urealyticum were 31.5% in 146 patients with gonococcal urethritis, 33.8% in 334 patients with non-gonococcal urethritis, 17.5% in non-bacterial chronic prostatitis and 27.5% in the other patients without infectious diseases, respectively; no significant difference was seen among these groups. U. urealyticum was detected in the urine from 32.1% of the 28% patients who were younger than 12. However, U. urealyticum was detected in the urine from 5.6% of the 18 patients who were older than 70. Therefore, there was no relationship between the age and U. urealyticum-positive rate in urine. Furthermore, there was no relationship between the detection of U. urealyticum and the subjective and objective findings in the patients with urethritis before and after the treatment. From these results, it is presumed that U. urealyticum has no pathogenicity in human genitourinary tract.     

DNA hybridization technique for the detection of Neisseria gonorrhoeae in men with urethritis

A technique to detect Neisseria gonorrhoeae directly in clinical specimens was developed using a modified DNA-hybridization method. It uses the gonococcal cryptic plasmid as the radiolabeled probe, can detect as few as 100 colony-forming units of N gonorrhoeae or as little as 0.1 pg of purified gonococcal plasmid DNA, and is highly specific. This technique for differentiating between gonococcal and nongonococcal urethritis was evaluated in men with symptomatic urethritis in Seattle. Sixty-three (89%) of 71 who had cultures positive for N gonorrhoeae were also positive by DNA hybridization, and all 42 whose cultures were negative were also negative by DNA hybridization. Five of six isolates from patients who were positive by culture but negative by hybridization lacked the gonococcal cryptic plasmid and belonged to a unique auxo-type which requires proline, citrulline, and uracil for growth.     

Antibodies to Neisseria gonorrhoeae: a study of the urethral exudates of 232 men.

The results of a study of the antibodies that react with Neisseria gonorrhoeae in the urethral exudates of 232 men who attended a clinic of the Department of Sexually Transmitted Diseases at Glasgow, Scotland, are presented. Of 132 men with gonorrhea, antibodies to the gonococcus were identified by use of an indirect immunofluorescent antibody test in 129 (98%): IgA antibody was found in all 129 (98%), IgG antibody in 119 (90%), and IgM antibody in 64 (49%). IgA antibody to the gonococcus was found in the secretions of only one (1%) of another 100 patients who did not have gonococcal urethritis (50 had nongonococcal urethritis and 50 had no evidence of urethritis). IgG antibody was found in 13 (26%) of the 50 men with nongonococcal urethritis and in none of the 50 men who had no evidence of urethritis. When treatment of gonorrhea was successful, the titers of IgA and IgM antibody declined rapidly and were generally undetectable within 14 days; the titers of IgG declined more slowly and could still be detected 28 days after treatment.     

Symptomatic and asymptomatic chlamydial non-gonococcal urethritis in Jamaica: the potential for HIV transmission

To determine the contribution of Chlamydia trachomatis to non-gonococcal urethritis (NGU) in men attending sexually transmitted disease (STD) clinics in Jamaica we studied men with NGU (n=339), and control groups including asymptomatic men who were STD contacts (n=61), asymptomatic men who were not STD contacts (n=32) and men with gonococcal urethritis (GU) (n=61). Urethral specimens were examined for C. trachomatis and Neisseria gonorrhoeae. Serological tests for syphilis (STS) and HIV-1 infection were also performed. C. trachomatis accounted for 63% of cases of NGU but high prevalences were also found in asymptomatic STD contacts (59%), asymptomatic STD non-contacts (78%) and men with GU (48%). The prevalence of C. trachomatis in men with GU differed significantly from that in men with NGU and asymptomatic STD non-contacts (P<0.05). C. trachomatis infection in men with NGU was associated with multiple sex partners (71% vs 58%; chi2=4.78; odds ratio (OR)=1.76; P<0.05) and previous history of gonococcal infection (83% vs 42%; chi2=59.8; OR=6.8; P<0.0001). Concomitant infection with HIV-1 occurred in 5.2% of cases of NGU and 50% and 90%, respectively, of the HIV-positive men had chlamydia or reactive STS. As a cost effective strategy in the control of STD and HIV we recommend presumptive treatment for C. trachomatis in men seeking STD treatment in Jamaica.