Title: ? ? ? ? (PROSTATITIS)
1? ? ? ?(PROSTATITIS)
2??????????? The Progress of Diagnosis and
Treatment of Prostatitis
3 ? ?
- ???????,?????????,???????????
- ?????????????????????,??????????????,?????????
4(No Transcript)
5(No Transcript)
6 ????
- ?????????????
- ?????????,
- ????????
- ???????,
- ?????????????
- ?????????,
- ??????????
7???????????
- ??????,???????????????,????????????????
- ??????????????????????????,?????????????,???????
????????????????????????? - ????????????????,??????????????????????
??????????????,??????????? -
8??????
- ?????????????,???????????????????????????????????
??????,??????????
9?????????
- ????????????,???????????,??????????????????
10 ???????
- ?????? ???????????,??????????????,??,?????
- ?????? ????????(?)??????????,????????????????????
????????
11???
- ?????50??????????????????????58.8(Mo
on ?,1997)?Stamey(1980)??????????????????????????
?????????25,??50??????
12????
13??????????
- ?????????
- (acute bacterial prostatitis ,ABP)
- ?????????
- (chronic bacterial prostatitis,CBP )
???? (prostatitis)
- ??????????
- (non or abacterial prostatitis,NBP)
14 ????????????????????????,????????????
???????(silent prostatitis),????????,???????????
???,E.P.S?????????
15??NIH?????
- 1995?,?????????(National Institute of
Health, NIH)??????????????,?NIH?????????1998??????
?????(International Prostatitis Collaborative
Network, IPCN)???
16 NIH????????
?? ?? ??
? ?????????(ABP) ??????????
? ?????????(CBP) ???????/??????????
? ??????????/????????(CPPS) ???????/??????????/???????
?A ???????? EPS/VB3/????????WBC
?B ????????? EPS/VB3/???WBC??
? ?????????(AIP) ??/EPS/VB3?????,??????
CPPS, chronic pelvic pain syndrome AIP,
asymptomatic inflammatory prostatitis
17 ? ?
- 90?????????????????????????????,?????
???????????????????????????????????,?????????(CPPS
)???NIH??????????????
18 19???????????(ABP)
- ???????????????????????,???????????????
???????
20???????????
- ???????????????????????,???????????????
?????????????????????
211.?????,6580 2..????????????????????? ????????,
1015 3.??,525
22????????????/????????(CPPS)
- ?A ??CPPS
- ??????????????????????,???????,????
???????????? -
23- ??,???????,?????
- ????????????,??-??
- -????????????CPPS???
- ???
24??
????
UDS?? (????????)
??
????
P
????
????
CPPS-??-???????
25- ?B ???CPPS
- ????????????,?
- ?E.P.S????????,?????
- ??????????????
26 ????(????)
??????
??????
?????????
????????????
???????????????
???
????????
????
????
????(? ?????
??????????????)
???????
?????
????????
27? ? ? ? ? ? ???
- ?????????????,????,?
- ???????????????????
- ???????????????????
- ?????????????????
28????
- ???????????,????,???????
- ???????????
- ????????????????
- ????????????
29?????????????
- ????
- ?????????????????????????????????
- ? ?????????????,???????
- ????????????????,?????????????,??????????????? ?
30?????????????
- ???????????????????????
- ???????????????????????
31???????????
32 33???????????(ABP)
- ??????,????????????????????????????????
????
34 DRE????????????? B?(TRUS)???????????? ?
?????,ABP??????????, ?????
35????????
- ??ABP??,?????????(??????)??????????????
,????????????????
36 1991?????????(NIH)????????????(NIH-chronic
prostatitis symptom index ,NIH-CPSI)??????,???????
????????????????????????????????????????????
37??????????
- ???????????? ????????????,???????????
??????????,????????????
381. E.P.S(expressed prostatic secretion) ??
- ????(? 400)?E.P.S????????10??15?,??????
??????????????????????????????????????
39??????
- ?a?WBC??, ?b?WBC??
- E????WBC????????????
- WBC???????????????????????
402. Meares-Stamey ??(????)
- ???????????CBP?NBP,??????????????????
??
41VB1 ???10ml VB2???10ml(
???200ml? E.P.S??????VB3????????10ml??? Meare
s-Stamey ??(????)
42? ?
- ??E.P.S?VB3???????/????????,???????????
???,?????????????,??????CBP(?)?NBP(?)???A? ?B?
433.????
- E.P.S?VB3???????(????????)?????????????
?????
444. ????????(transrectal ultrasound of the
prostate ,TRUSP)?????????????
- TRUS ???????????????????????????????????
???CT?MRI???TRUS?????????????
45 CPS?TRUS????
???????????(???????????) ???????? ???????? ?????????????????? ?/??????
46???IPCN?????CPPS???? (Washington,2000)
? ? ? ?
? ? ????(DRE?)??????
? ? ???????NIH-CPSI????????????(?????????)
? ? ??????????????????????(?????EMG)????TRUS??CT?MRIPSA
??(??????????)????????6???3??
47 48???????????(?)
- ???????????????,???????????????????????
,????????(???????????)?
49??????? ? ? ?
- ?????????????,?????????????????,??????????????
- ????????????????????????????????,?????????????
50??????????????????? ???????????????????? ???????
CUA2007??????????
51????????(???)
- 1. ?????????( ?)
- ????????????????????????????CBP????????
?????????????
52 - ???????????????,??????????????????(????
???????????,???????)?a1-???????????????????,?????
???????????
532. ??????????( ?)
- ??NBP,????????????,??????,???????????????
??????????
54 ??CPPS( ?A)?????????
- a1-?????/???????(?????6???, a1-???????????12???)
- ????
- ????(??????,?????????)
- ???????? ?????,????-2(COX2)????
- ???
- ??(?????,????????)
- ???(????)
- ????
- ??????
55 ???CPPS( ?B)?????????
- ???(?????)
- ??? ????????????2(COX2)???
- a1-?????
- ??????
- ??????
56- ?????
- ????
- ??????????????????
- ???????????,??????????????,????,???????
- ??????????????
57CPPS??????
????????? ???????????????????,?????? ??????????(
??????????) ?????????????? ???????CPPS,??33???
???? (Nadler, Urology,2002 Ye
ZQ,Asian J Androl,2003)
58- ??????????
- ?????
- ??????
- ??
- ???????/??????????? ????????
593. ??????????
- ??????,????????? ????????????
60? ? ? ? ? ? ? ? ? ?
- ????????????????? 1???????? 2?????????????
? 3??????????? 4??????????,???????
??????????????????,???????????????????
61?????????????
- ????????
- ?????????????
- ?????(???????)?CPPS???
- ????,.????????????CPPS??,????????????????????
??? - ?A??B???
- ???????????????(?????????????)?
- ????(????E2????-1ß???????-a)??????
62?????????????
- ?????????? ????????
- ??????????????????????????????????????????????????
??? - ????????????????,
63??????????? ??
- ?????????????????
- ???????????,??????????????????????????
- ????????????
64 ? ?
65??!