低能量冲击波治疗难治性前列腺盆腔综合征6个月疗效分析

An analysis of 6-month follow-up efficacy of low-intensity extracorporeal shock wave therapy for refractory prostate-pelvic syndrome

摘要

目的 评估低能量冲击波治疗难治性前列腺盆腔综合征的长期疗效及安全性。方法 回顾性分析2020年1月-2023年1月于首都医科大学附属北京积水潭医院泌尿外科接受低能量冲击波治疗的173例难治性前列腺盆腔综合征患者的临床资料。所有患者均接受会阴部低能量冲击波治疗，1次/周，连续8周。比较患者治疗前、治疗后当时（疗程结束时）及治疗后1、3、6个月美国国立卫生研究院-慢性前列腺炎症状指数（NIH-CPSI）、国际前列腺症状评分（IPSS）、视觉疼痛模拟量表评分（VAS）及国际勃起功能指数5评分（IIEF-5）的变化。结果 共有142例（82.1%）患者完成全部随访。患者治疗后当时及治疗后1、3、6个月的NIH-CPSI、IPSS、VAS、IIEF-5均较治疗前明显改善，差异有统计学意义（P＜0.01）。所有患者随访全程未见明显不良反应及并发症发生。治疗后当时NIH-CPSI下降≥6分的患者有115例（81.0%）；IPSS下降≥3分的患者有99例（69.7%）；VAS下降≥3分的患者有121例（85.2%）；IIEF-5升高≥4分的患者有105例（73.9%）。治疗后6个月时，上述治疗有效的患者均可以维持令人满意的疗效。结论 采用低能量冲击波治疗难治性前列腺盆腔综合征，能显著改善患者的临床症状，提高其生活质量，疗效至少可维持6个月。

Abstract

Objective To evaluate the long-term efficacy and safety of low-intensity extracorporeal shock wave therapy (Li-ESWT) for refractory prostate-pelvic syndrome (PPS). Methods Clinical data of 173 patients with refractory PPS undergoing Li-ESWT at our hospital during Jan. 2020 and Jan. 2023 were retrospectively analyzed. All patients received weekly treatment for 8 consecutive weeks. Changes in the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), international prostate symptom score (IPSS), visual analog scale (VAS), and international index of erectile function-5 (IIEF-5) were compared before treatment, immediately, 1, 3, and 6 months after treatment. Results A total of 142 patients (82.1%) completed all follow-ups. Compared to baseline data, there was a statistically significant improvement in NIH-CPSI, IPSS, VAS, and IIEF-5 scores immediately after treatment and 1, 3, and 6 months after treatment (P<0.01). No significant adverse reactions or complications were observed throughout the follow-up. At the time of treatment completion, 115 patients (81.0%) had a decrease of ≥6 in NIH-CPSI; 99 patients (69.7%) had a decrease of ≥3 in IPSS; 121 patients (85.2%) had a decrease of ≥3 in VAS; 105 patients (73.9%) had an increase of ≥4 in IIEF-5. At the 6-month follow-up, patients who responded to treatment maintained satisfactory therapeutic effects. Conclusion Li-ESWT can significantly improve clinical symptoms and quality of life for patients with refractory PPS, with therapeutic effects lasting at least 6 months.

关键词

低能量冲击波 / 前列腺盆腔综合征 / 慢性前列腺炎 / 慢性骨盆疼痛综合征

Key words

low-intensity extracorporeal shock wave therapy / prostate-pelvic syndrome / chronic prostatitis / chronic pelvic pain syndrome

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