中国全科医学 ›› 2018, Vol. 21 ›› Issue (36): 4531-4536.DOI: 10.12114/j.issn.1007-9572.2018.36.023
李显永,赵晖,官润云*,顾鹏,陈跃龙
出版日期:
2018-12-20
发布日期:
2018-12-20
基金资助:
LI Xianyong,ZHAO Hui,GUAN Runyun*,GU Peng,CHEN Yuelong
Published:
2018-12-20
Online:
2018-12-20
摘要: 目的 探讨前列腺脓肿(PA)临床特征,为临床治疗提供参考。方法 选取2005年1月—2017年10月昆明医科大学第一附属医院收治的4例PA患者,在PubMed以“prostate abscess OR prostatic abscess”为标题或关键词检索2007年11月—2017年11月相关文献并进行PA的临床特征分析。结果 4例患者中有糖尿病病史2例,导尿史1例,前列腺增生1例;1例直肠指检触及波动感;2例患者脓液细菌培养为大肠埃希菌;均经手术治疗后痊愈。文献共纳入379例PA患者,其中糖尿病(28.0%)、尿道侵入性操作(12.9%)、免疫抑制(7.1%)是PA的主要易感因素;发热(59.6%)、尿路刺激征(36.7%)、疼痛(33.5%)为主要临床表现;大肠埃希菌(26.4%)、肺炎克雷伯杆菌(13.5%)、金黄色葡萄球菌(7.1%)为常见致病菌;多数患者需手术治疗。结论 PA早期症状无特异性,诊断困难,对疑似病例应及时行经直肠B超、CT或磁共振成像(MRI)明确诊断,治疗主要以敏感抗生素、经直肠PA穿刺引流术和经尿道PA去顶引流术为主。
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