经尿道电灼联合肝素及碱化利多卡因膀胱灌注在间质性膀胱炎治疗中的作用

发布时间：2018-10-30 09:37

【摘要】：目的评价经尿道电灼联合肝素及碱化利多卡因膀胱灌注对间质性膀胱炎/膀胱疼痛综合征(IC/BPS)的治疗效果。方法回顾性分析2014年1月至2015年6月间治疗的31例IC/BPS患者的临床资料。椎管内麻醉或全麻下行经尿道膀胱病变电灼及电刀切取病理,明确诊断后给予肝素及碱化利多卡因膀胱灌注治疗(肝素25 000 U、2%利多卡因10 m L及5%碳酸氢钠5m L,保留60~120 min),每周灌注1次,8周后每月2次。于治疗前及治疗后第l和第6个月记录O’Leary-Sant间质性膀胱炎指数、视觉模拟疼痛评分、生活质量评分、每日排尿次数、最大膀胱容量的变化及膀胱灌注治疗的不良反应。结果随访时间6~24个月,28例(90.32%)于治疗后第1和第6个月O’Leary-Sant间质性膀胱炎指数、视觉模拟疼痛评分、生活质量评分、每日排尿次数和最大膀胱容量均有改善,与治疗前相比均有统计学差异(P0.01),无明显不良反应;3例(9.68%)女性患者治疗效果不佳,其中2例行膀胱全切术,术后症状消失,1例术后病理报告合并膀胱原位癌变。结论经尿道电灼联合肝素及碱化利多卡因膀胱灌注对IC/BPS是一种安全有效的治疗方法。
[Abstract]:Objective to evaluate the efficacy of transurethral cauterization combined with heparin and lidocaine in the treatment of interstitial cystitis / bladder pain syndrome (IC/BPS). Methods the clinical data of 31 patients with IC/BPS from January 2014 to June 2015 were retrospectively analyzed. Transurethral cauterization and electrosurgical resection of bladder lesions were performed under intraspinal or general anesthesia. Heparin and lidocaine were given after diagnosis (heparin 25 000 UU 2% lidocaine 10 mL and 5% sodium bicarbonate 5m L). The rats were perfused once a week for 60 ~ 120 min), and twice a month after 8 weeks. The O'Leary-Sant interstitial cystitis index, visual analogue pain score, quality of life score, the number of urination times per day, the change of maximal bladder volume and the adverse reactions of bladder perfusion therapy were recorded before and at 1 and 6 months after treatment. Results the follow-up time ranged from 6 to 24 months. 28 cases (90.32%) had improved O'Leary-Sant interstitial cystitis index, visual analogue pain score, quality of life score, daily urination times and maximal bladder volume at the 1st and 6th month after treatment. Compared with before treatment, there were statistical differences (P0.01), no significant adverse reactions; 3 cases (9.68%) of female patients were treated poorly, 2 cases underwent total cystectomy, the symptoms disappeared after operation, and 1 case was pathologically complicated with bladder carcinoma in situ. Conclusion transurethral cauterization combined with heparin and lidocaine is a safe and effective method for the treatment of IC/BPS.
【作者单位】：中国医科大学附属第一医院泌尿外科;
【基金】：辽宁省教育厅科学技术研究项目(12010635) 辽宁省自然科学基金(201102260)
【分类号】：R694.3

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