庆大霉素局部注射和肌内注射治疗慢性细菌性前列腺炎的疗效对比

目的 比较局部注射和肌内注射庆大霉素治疗慢性细菌性前列腺炎的临床疗效.方法 将24例慢性细菌性前列腺炎患者按就诊先后顺序随机分为A组和B组.A组12例患者为前列腺内直接注射给药,庆大霉素80 mg,1次/2 d;B组12例患者为肌内注射给药,庆大霉素80 mg,1次/d.A组患者给药3次后,B组患者给药6次后,应用放射免疫分析法测定前列腺液和血清中庆大霉素浓度,同时测定前列腺液pH值.结果 A组患者治疗总有效率100.0％ (12/12),B组总有效率33.3％ (4/12),差异有统计学意义(P＜0.05).给药后1、4、24h和1周后,A组患者前列腺液庆大霉素浓度均比血清中高,差异均有统计学意义[1 h:(14 833±10 684) μg/L比(3267±1105) μg/L;4 h:(11 208 ±5675) μg/L比(1257±335) μg/L;24 h:(1554±696)μg/L比(272±97) μg/L；1周:(487±127) μg/L比(0±0) μg/L,均P＜0.01]；B组患者前列腺液庆大霉素浓度均比血清中低,差异均有统计学意义[1 h:(217±213) μg/L比(2643±811) μg/L;4 h:( 700±244) μg/L比(1170±256) μg/L;24h:(206±118) μg/L比(766±234) μg/L；1周:(39±7) μg/L比(23±9) μg/L,均P＜0.01]；A组患者前列腺液中庆大霉素浓度与B组患者比较,差异均有统计学意义(均P＜0.01).治疗前后,A组患者前列腺液pH值差异有统计学意义[(8.3±2.2)比(6.3±1.8),P＜0.05]；B组患者前列腺液pH值差异无统计学意义[(8.3±2.4)比(8.1±2.1),P＞0.05].结论 局部注射庆大霉素治疗慢性细菌性前列腺炎较肌内注射疗效更好.

Clinical observation of partial gentamicin injection in treating chronic prostatitis

Objective To observe the clinical curative effect of local injection and intramuscular injection of gentamicin in the treatment of chronic bacterial prostatitis. Methods Twenty-four patients were divided into group A and group B. The group A had 80 mg （ gentamicin injected into prostate every other day）. The group B had 80 mg（ gentamicin by intramuscular injection ）. The method of radioimmunoassay was adopted to determine the gentamicin concentration in prostate fluid and serum. Results Total effective rate in group A was 100. 0% and it was 33.3% in group B; the difference was statistically significant （P 〈0. 05）. After medical administration 1, 4, 24 hours and 1 week, group A patients＇ prostatic fluid gentamicin concentration was higher than that in serum, the difference was statistically significant [ 1 h： （14 833 ± 10 684） μg/L vs （3267 ± 1105） μg/L;4 h： （11 208 ± 5675 ） vg/L vs （ 1257 ± 335 ） μg/L ; 24 h ： （ 1554 ± 696 ） μg/L vs （ 272 ± 97 ） μg/L; 1 week ： （487 ± 127 ） μg/L vs （ 0 ±0） μg/L, all P 〈 0. 01 ]. Group B patients＇ prostatic fluid gentamicin concentration was higher than that in serum, the difference was statistically significant [ 1 h： （217 ± 213） p.g/L vs （2643 ± 811 ） μg/L;4 h： （700 ± 244 ）μg/L vs （ 1170 ± 256 ） vg/L ;24 h ： （ 206 ± 118 ） μg/L vs （ 766 ± 234 ） μg/L; 1 week ： （ 39 ± 7 ） μg/L vs （ 23 ± 9 ）μg/L, all P 〈 0. 01 ] ;prostatic fluid concentration of gentamicin in group A and group B had significant difference （ all P 〈 0.01 ）. Conclusion Local injection of gentamicin treatment of chronic bacterial prostatitis is better than the efficacy of intramuscular injection.