经直肠超声引导下前列腺穿刺活检术后全身炎症反应综合征相关因素分析及护理对策

目的探讨经直肠前列腺穿刺术(TRUSPB)后全身炎症反应综合征(SIRS)的相关因素与护理对策。方法选取311例接受TRUSPB患者的临床资料。其中发生SIRS 20例(6.43%)。采用单因素四格表χ2检验和多因素Logistic回归分析方法探讨术后SIRS的危险因素和护理对策。结果慢性细菌性前列腺炎、尿路感染、急性生理与慢性健康评分差、脑血管意外史、糖尿病、前列腺体积45 m L、反复穿刺及年龄是TRUSPB后SIRS的相关因素。经Logistic回归分析,慢性细菌性前列腺炎、尿路感染、APACHEⅡ评分差、糖尿病、既往脑血管意外、前列腺体积45 m L为术后SIRS的独立危险因素(P0.05)。结论分析拟行TRUSPB后SIRS的危险因素,并针对性采取预防性护理措施,可降低术后SIRS发生率。     

经直肠超声引导下前列腺穿刺活检术后全身炎症反应综合征的危险因素

目的探讨经直肠前列腺穿刺术(TRUSPB)术后引发全身炎症反应综合征(SIRS)的危险因素。方法对2010年1月至2014年11月收治的前列腺穿刺活检的751例患者进行回顾性分析,运用单因素四格表χ~2检验及多因素Logistic回归分析的统计学方法,筛选术后发生SIRS的危险因素。结果 751例患者穿刺术后发生SIRS 49例,感染率为6.52%,其中感染性休克1例占0.13%;经四格表χ~2检验,慢性细菌性前列腺炎、尿路感染、急性生理与慢性健康评分(APACHEⅡ)评分差、既往脑血管意外、糖尿病、近期多次外科手术、前列腺体积45mL、反复穿刺、年龄等9个因素与穿刺术后SIRS相关(P0.05);经非条件二分类Logistic回归分析,慢性细菌性前列腺炎、尿路感染、APACHEⅡ评分差、糖尿病、既往脑血管意外、前列腺体积45mL等6个因素为穿刺术后SIRS的危险因素(P0.05)。结论分析待穿刺患者相关危险因素,加强对存在相关危险因素特别是多个危险因素患者的预防控制,可降低术后SIRS的发生率。     

慢性前列腺炎患者的心理社会因素调查

目的探讨慢性前列腺炎忠者的心理社会因素。方法采用症状自评量表和社会支持评定量表对156例慢性前列腺炎患者进行测试，并与156例健康人作对照。结果慢性前列腺炎患者躯体化、抑郁、焦虑、恐怖等因子分明显高于对照组，差异有显著性（P〈0．05）。慢性前列腺炎患者的客观、主观支持及支持总分均低于健康对照组，差异有显著性（P〈0．05）。结论慢性前列腺炎患者心理健康状况较差、社会支持低，在进行躯体治疗时应实施心理干预。     

慢性前列腺炎患者精神心理症状相关因素分析

目的:探讨慢性前列腺炎患者的精神心理症状的发生情况及相关因素。方法:选择符合慢性前列腺炎诊断的315例患者作为研究对象,详细询问并记录病程、以往治疗情况和精神心理症状,进行前列腺炎临床症状评分、前列腺按摩液(EPS)检查,并将诸多因素与精神心理症状进行相关性比较。结果:慢性前列腺炎患者中具有精神心理症状者161例(51.1%)。慢性前列腺炎患者的精神心理症状与病程无关,病程<1年、1~2年和>2年患者的精神心理症状发生率分别为49.1%、48.0%和56.1%;与疾病久治不愈有关,初次就诊、2~3次就诊和多次就诊患者的精神心理症状发生率分别为35.3%、43.5%和62.6%,差异具有显著性(P<0.05);与临床症状的严重程度无关,轻、中程度和重症患者的精神心理症状发生率分别为46.2%、52.4%和55.9%;与EPS内的炎症程度无差异(P>0.05),炎性慢性前列腺炎和非炎性慢性前列腺炎患者的精神心理症状发生率分别为53.8%和47.3%。结论:慢性前列腺炎患者精神心理症状与患者的多次就诊直接相关,疾病久治不愈加重了患者的精神心理症状。     

难治性慢性前列腺炎患者精神因素与勃起功能的初步探讨

目的:探讨难治性慢性前列腺炎患者的精神因素与勃起功能。方法:选取未经心理治疗的232例难治性和非难治性慢性前列腺炎患者分别进行NIH慢性前列腺炎症状评分、焦虑、抑郁评分和勃起功能评分并进行对比。结果:难治性慢性前列腺炎患者的NIH慢性前列腺炎症状评分与非难治性患者无显著性差异,难治性慢性前列腺炎患者焦虑和抑郁评分分别高于非难治性患者焦虑和抑郁评分(P<0.01),难治性慢性前列腺炎患者勃起功能明显低于非难治性患者(P<0.01);慢性前列腺炎的焦虑抑郁评分与勃起功能评分有显著性负相关性。结论:难治性慢性前列腺炎患者会存在明显的心理症状,并且在某种程度上影响到其勃起功能。     

慢性前列腺炎患者信息需求与支持需求调查研究

目的 探讨慢性前列腺炎(CP)患者信息与支持需求,为临床开展有效护理干预提供依据.方法 采用症状自评量表、自制慢性前列腺炎信息需求与支持需求调查表,对186例慢性前列腺炎患者进行调查.结果 各需求因素得分排前5位的是:性生活指导、疾病预防措施、医生心理指导、配偶支持、疾病反复难治的原因.30～岁组、本科及以上学历、病程1～2年、局部加全身症状组信息与支持需求最高(均P＜0.05).结论 CP患者信息需求较高,应重视患者需求及护理干预重点人群,采取个性化的心理指导,帮助患者建立良好的行为方式,调动家庭支持系统的作用,以促进患者康复.     

上海市徐汇区前列腺癌患者的危险因素研究

目的 探索前列腺癌发病的危险因素和保护因素,为预防前列腺癌发病提供依据. 方法 采用1:1匹配的病例对照研究方法,用专门设计的调查表对我科148例前列腺癌病例及148例非肿瘤患者进行1对1的询问调查,采用条件logistic回归分析法对所获得的调查资料进行统计学分析. 结果 单因素分析显示:高龄、肥胖、睾酮水平高、有前列腺炎和有输精管术结扎术史是前列腺癌的危险因素,首次遗精时间晚及首次性生活时间晚是前列腺癌的保护因素.多因素分析显示:高龄、肥胖及有前列腺炎是前列腺癌的危险因素,首次遗精时间晚及首次性生活时间晚是前列腺癌的保护因素. 结论 前列腺癌的发病是多因素共同参与的结果.     

心理干预对难治性慢性前列腺炎患者心理状态的影响

目的 探讨心理干预对难治性慢性前列腺炎患者心理健康状态的影响.方法 将120例难治性慢性前列腺炎患者按门诊就诊顺序分为观察组和对照组各60例.两组均给予药物治疗、前列腺注射、热水坐浴等综合治疗及常规护理干预,观察组在此基础上给予心理干预.3个月后应用症状自评量表(SCL-90)评定患者心理健康状况.结果 干预后观察组SCL-90各因子评分及总均分显著低于对照组(均P＜0.05).结论 心理干预可有效改善难治性慢性前列腺炎患者的心理状态.     

复杂胫骨平台骨折术后并发膝关节僵硬的高危因素分析

目的分析手术治疗复杂胫骨平台骨折术后并发膝关节僵硬的高危因素。方法回顾性分析自2001-01—2013-01诊治的190例SchatzkerⅤ、Ⅵ型复杂胫骨平台骨折,其中40例(21.1%)术后并发膝关节僵硬。采用单因素Logistic回归分析术前、术中、术后共22个临床评估因素,对上述有意义的影响因素(P0.05)再采用多因素Logistic回归分析确定复杂胫骨平台骨折术后并发膝关节僵硬的高危因素。结果通过单因素Logistic回归分析确定导致复杂胫骨平台骨折术后膝关节僵硬的相关因素包括:合并膝关节周围损伤、高能量损伤、肥胖、关节面复位质量、石膏制动时间、伤口感染、软组织缺损、关节异位骨化、规范康复指导、下肢深静脉血栓形成。通过多因素Logistic回归分析确定导致复杂胫骨平台骨折术后膝关节僵硬的高危因素包括:合并膝关节周围多处损伤、关节面恢复质量差、术后长时间石膏制动、术后缺乏规范化的康复治疗、膝关节周围异常骨化、皮肤软组织广泛缺损。结论关节面恢复质量欠佳、长时间石膏制动、膝关节周围异位骨化及缺乏积极主动功能锻炼将严重影响患者术后关节功能康复质量,并可能导致膝关节僵硬。     

宁波市江东区社区2型糖尿病患者危险因素分析

目的 探讨社区2型糖尿病患者的主要危险因素,为制定防治措施提供科学依据.方法按既定的纳入标准选取病例280人,和对照组患者280人和283人,采用自行设计的问卷进行面对面的访问式调查.对研究因素进行单因素和多因素Logistic回归分析.结果单因素Logistic回归分析显示除冠心病史、脑卒中史外,其余11项指标均有统计学意义.多因素Logistic回归分析结果显示高文化程度、体育锻炼等因素对2型糖尿病患者有负效应,而高血脂史、糖尿病家族史、吸烟、主食摄入量、高BMI等因素产生正效应.结论对社区2型糖尿病高危人群进行危险因素的控制有助于有效预防和控制2型糖尿病.     

青年人群中前列腺炎样症状及其相关因素的调查

目的:了解青年人群中前列腺炎样症状发病情况;研究与前列腺炎样症状有关的危险因素。方法:应用NIH-CPSI和自行设计的前列腺炎相关因素问卷对潍坊市潍城区2500例青年男性(年龄18~30岁)进行调查,收集相关信息,进行病例对照研究,筛选前列腺炎样症状发生的危险因素。结果:共回收问卷2382份,其中2125份填写完整。128例(6.02%)被确认有前列腺炎样症状,疼痛症状评分(6.98±0.29)分,排尿症状评分(3.77±0.25)分,其中39例有中~重度前列腺炎样症状。相关因素中久坐习惯、憋尿习惯、生活或工作中经常感巨大压力、频繁手淫、寒冷的工作环境等可能是前列腺炎样症状发生的危险因素。结论:青年人群中前列腺炎样症状常见,一些内在因素和环境因素可能是前列腺炎样症状发生的危险因素,指导患者改变不良生活习惯,避免相关危险因素,对预防和减少前列腺炎发作是有益的。     

Diagnosis of chronic prostatitis by noninvasive methods in elderly patients with benign prostatic hyperplasia in China

Chronic prostatitis is hard to be identified in BPH patients in clinical works. This study aimed to diagnose chronic prostatitis in BPH patients by noninvasive methods. BPH patients who received transurethral resection of prostate from January 2014 to July 2015 were enrolled in current study. Patients were received examinations of PSA, sex hormones, inflammatory cytokines, metabolic panel and transrectal ultrasonography. According to histological results, patients were divided into two group of BPH with/without prostatitis. Logistic regression was used to find risk factors of chronic prostatitis. As a result, 181 men with an average age of 72.15 ± 8.41 years were enrolled in this study, including 116 patients with prostatitis and 65 patients without prostatitis. The storage sub-score, PSA and IL-2R were significantly higher in patients with prostatitis than those without prostatitis. Based on logistic regression analysis, the above three parameters were also the risk factors of BPH with prostatitis. The diagnostic model was calculated as: 0.317 × storage sub-score + 0.092 × PSA + 0.003 × IL-2R − 4.296. The AUC was 0.725. Histological prostatitis in BPH patients can be diagnosed by the combination of serum IL-2R, PSA and storage sub-score. Identification of chronic prostatitis in BPH patients could more efficiently alleviate urinary symptoms and reduce the risk of disease progression.     

Epidemiologic risk factors for chronic prostatitis

Chronic prostatitis/chronic pelvic pain syndrome is a multifactorial problem, which affects men of all ages and in all demographics. Recent studies have shown that the prevalence of prostatitis is approximately 2-10% among unselected men in North America, Europe and Asia. This data clearly indicates that chronic prostatitis constitutes an important problem in international health care. Nevertheless, the aetiology and pathogenesis of chronic prostatitis have yet to be clearly delineated, despite the numerous efforts which have been made, with regard to both basic and clinical research. In fact, factors other than leucocytes and bacteria have been shown to contribute to the symptoms typically associated with prostatitis. Studies of the epidemiology and determinants of prostatitis risk factors may also provide clues to the general aetiology of prostatitis. Other epidemiological data appears to indicate that certain as-yet-unknown factors might be associated with an increased tendency towards the development of chronic prostatitis. However, findings from most studies are considered to represent only preliminary data, because of the small sample sizes or lack of generalizability inherent to most of the studies. The identification and characterization of these relevant risk factors might accelerate or augment the development of preventive, diagnostic, and therapeutic strategies for the treatment of these syndromes.     

Distal urethral web: a risk factor in prostatitis

This study aims to identify a risk factor in the form of a distal urethral web in chronic prostatitis, resection of which should lead to significant symptom reduction. The distal urethral web has been identified as a risk factor in chronic prostatitis, surgical resection of which resulted in reduction of symptoms as measured by the prostatitis specific symptom indexes. A risk factor in chronic prostatitis has been identified as a reflux-causing distal urethral web, surgical resection of which resulted in significant symptom severity reduction and a smaller decline in the frequency of symptoms. Overall, this study shows that the distal urethral web is a risk factor for chronic prostatitis and chronic pelvic pain syndrome, and that its resection resulted in significant symptom severity reduction with a lesser decline in the frequency of symptoms. This would indicate that the patients rated surgery as having an overwhelming edge when it came to reducing the severity of symptoms, but not so overwhelming an edge as far as the frequency of symptoms was concerned. This is probably reflective of the patients' choice for a combination of surgery and conventional treatments rather than one or the other alone, and/or other risk factors as yet undiscovered. Like other treatments in the past, this may not be the complete answer to chronic pelvic pain syndrome (CPPS).     

Prevalence of sexual dysfunction in Chinese men with chronic prostatitis

OBJECTIVE: To investigate the prevalence and risk factors of sexual dysfunction in Chinese men with chronic prostatitis. PATIENTS AND METHODS: A questionnaire survey was conducted among 2000 men diagnosed as having chronic prostatitis using the National Institutes of Health Chronic Prostatitis Index and analysis of expressed prostatic secretions. The survey was designed to elicit information about age, height, weight, occupation and history of disease and treatment. The erectile capacity of the men was assessed using the five-question version of the International Index of Erectile Function. RESULTS: Of the 2000 men with chronic prostatitis selected, 1786 completed the survey; the overall prevalence of sexual dysfunction in these patients was 49%. The prevalence of premature ejaculation and erectile dysfunction accounted for 26% and 15%, respectively; 7.7% had both premature ejaculation and erectile dysfunction. There was a negative correlation between prevalence and age, and with the duration of chronic prostatitis (both P < 0.001). CONCLUSIONS: The prevalence rate of sexual dysfunction in Chinese men with chronic prostatitis is high and related to age.     

慢性前列腺炎在急性附睾炎发病中的关联度分析

目的 探讨慢性前列腺炎(CP)在急性附睾炎(acute epididymitis.AE)发病中的作用及两者发病的关联度.方法 将1998年1月至2009年1月年以来222例慢性前列腺炎与181例急性附睾炎患者随机分为急性附睾炎组及慢性前列腺炎组,比较AE伴有CP发病率与CP伴发AE的发病率,分析两者发病率差异性及关联度.结果 急性附睾炎组同时伴发慢性前列腺炎发病率为96.68%(175/181例),未伴发CP者6例.慢性前列腺炎组急性附睾炎发病率为13.96%(31/222例),未伴发CP者191例.附睾炎组CP发病率高于慢性前列腺炎组AE发病率,采用t检验两者差异有统计学意义.结论 附睾炎组CP发病率明显高于慢性前列腺炎组AE发病率,CP的存在是急性附睾炎发病的重要基础性因素,但不能排除急性附睾炎引起前列腺炎的可能,两者有重要关联度.     

Prognosis of patients with new prostatitis/pelvic pain syndrome episodes

PURPOSE: Little is known about the natural history of nonbacterial prostatitis/male pelvic pain syndrome, the transition from acute to chronic pelvic pain and risk factors for chronicity. In this study we determined the course of symptoms after physician visits for new nonbacterial prostatitis/pelvic pain syndrome episodes, and determined predictors of symptom persistence 1 year later. MATERIALS AND METHODS: A total of 286 male health maintenance organization enrollees (87% white, mean age 46.7 years, 83% completed the 12-month followup) with recent physician visits for new prostatitis/pelvic pain episodes completed baseline, and 3, 6 and 12-month followup telephone interviews, including the National Institutes of Health Chronic Prostatitis Symptom Index in a prospective longitudinal inception cohort study. RESULTS: On average symptoms improved substantially during months 1 to 3, modestly from months 3 to 6 and then remained unchanged. At each followup outcomes were better for men whose initial visit was for a first lifetime episode compared with a recurrent prostatitis/pelvic pain episode. Patients with more severe symptoms (Wald chi-square 11.27, p = 0.0008) and whose episode was recurrent (OR 2.2, 95% CI 1.16 to 4.06) at baseline were significantly more likely to report symptoms 1 year later. CONCLUSIONS: Most men who make physician visits for new nonbacterial prostatitis/pelvic pain episodes experience symptom improvement during the next 6 months. However, chronic, mild, persistent or recurrent symptoms are common. Patients with previous episodes and more severe symptoms are at higher risk for chronic pelvic pain.     

Epidemiology of prostatitis: new evidence for a world-wide problem

We review new data on the epidemiology of chronic prostatitis. These population-based studies used reasonable case-definitions to survey various populations from North America, Europe and Asia. Overall, 2-10% of adult men suffer from symptoms compatible with chronic prostatitis at any time and approximately 15% of men suffer from symptoms of prostatitis at some point in their lives. Other epidemiologic data suggest that chronic prostatitis may be associated with an increased risk for development of benign prostatic hyperplasia and prostate cancer. These data suggest that chronic prostatitis is an important international health care problem that merits increased priority from clinicians and researchers.     

慢性非细菌性前列腺炎患者前列腺液革兰阴性菌16SrRNA基因的检测

目的　探讨慢性非细菌性前列腺炎的可能病因。　方法　应用PCR方法检测 2 4例慢性非细菌性前列腺炎患者和 10例正常人前列腺液中革兰阴性菌 16SrRNA基因。同时对 10例实验组患者行尿道分泌物PCR检查。　结果　 2 4例慢性非细菌性前列腺炎患者前列腺液中革兰阴性菌16SrRNA基因阳性 13例 ,阳性率 5 4 % ;10例正常人中阳性 1例 ,阳性率 10 % (P <0 .0 1)。 10例慢性非细菌性前列腺炎尿道分泌物PCR均阴性。　结论　慢性非细菌性前列腺炎患者前列腺液革兰阴性菌 16SrRNA基因阳性率显著高于正常人。革兰阴性菌 16SrRNA基因源于前列腺而非尿道。一些目前还不能常规成功培养的细菌可能为慢性非细菌性前列腺炎的发病原因之一。