前列腺脓肿12例诊疗分析

目的 总结前列腺脓肿患者的临床表现及影像学特点,提升诊断符合率,同时为临床治疗提供一定的参考.方法 回顾2006年2月至2014年9月本院12例诊断为前列腺脓肿患者的既往病史、临床表现、实验室检查及影像学表现特点,总结其诊疗特点及临床疗效.结果 最常见的临床表现及体征为寒颤、发热及尿路刺激症状;9例尿培养阳性,培养结果以大肠杆菌为主(7/9),穿刺液培养亦以大肠杆菌为主(8/9),其中4例行经直肠超声引导下前列腺穿刺引流术及5例行经尿道前列腺脓肿电切去顶引流术,术后予以抗感染而控制病情;术后随访3个月,其中单纯抗感染治疗复发2例.结论 直肠指诊、PSA、经直肠超声及CT检查有助于尽早诊断前列腺脓肿,CT可准确反应脓肿的大小、位置及分隔情况,可作为诊断前列腺脓肿的常规检查;超声引导下穿刺引流或经尿道前列腺脓肿电切去顶引流术可有效控制病情.

Prostatic abscess: a retrospective review of 12 cases

Objectives To investigate clinical characteristics and diagnosis of prostatic abscess and improve diagnostic accuracy of this disease.And in order to provide a reference for clinical treatment of this disease.Methods This retrospective study was undertaken to review the 12 patients with prostatic abscess in our hospital from February 2006 to September 2014.12 cases of treatment characteristics and clinical efficacy were summarized.Results A total of 12 pathology-proven cases of prostatic abscess which treated at our institute were included in the study.Chills,fever and urinary irritation symptoms were the most common presenting symptom.Urine culture and puncture fluid culture were positive in 9 cases and the most common bacteria was escherichia coli.4 cases were undertaken transrectal ultrasound guided prostate puncture drainage,and 5 cases were undertaken transurethral prostatectomy with puncture and drainage.Antibacterials were used to all these 9 patients.2 cases of just used antibacterials lonely were recurred in 3 months follow-up.Conclusions The ability to diagnose prostatic abscess will considerably improved with the use of digital rectal examination,PSA,transrectal ultrasound and CT.CT can accurately reflect the size,location and separation of the abscess.The transurethral prostatectomy with puncture and drainage is an effective treatment method for prostatic abscess.