膀胱水扩张联合灌注透明质酸钠治疗间质性膀胱炎的临床研究

卢宝健; 尚芝群; 张卫; 孙二琳; 王丽宁; 念学武; 韩瑞发

doi:10.13201/j.issn.1001-1420.2015.05.013

膀胱水扩张联合灌注透明质酸钠治疗间质性膀胱炎的临床研究

- 天津医科大学第二医院泌尿外科, 天津市泌尿外科研究所, 天津市泌尿外科基础医学重点实验室(天津, 300211)
基金项目:
国家自然科学基金资助项目（编号81302211）；天津市卫生局科技基金资助项目（编号2013KZ107）

详细信息

通讯作者: 韩瑞发,E-mail:Han-ruifa@hotmail.com

中图分类号: R694

收稿日期: 2014-10-02

Clinical research of bladder hydrodistention combined with sodium hyaluronate irrigation for treatment of interstitial cystitis

- Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tiannjin Key Laboratory of Basic Medicine of Urology, Tianjin, 300211, China

More Information

Corresponding author: HAN Ruifa, E-mail: Han-ruifa@hotmail.com

Received Date: 02 October 2014

摘要

摘要: 目的：探讨间质性膀胱炎（IC）的临床诊断与治疗方法，评估膀胱水扩张加透明质酸钠灌注治疗IC的临床有效性及安全性。方法：2009年5月~2014年3月采用美国国立糖尿病、消化及肾病协会（NIDDK）制定的标准诊断IC患者60例，均在麻醉下行膀胱镜检查加水扩张术，术后第2~3天用无菌透明质酸钠液40 mg/50 ml行膀胱灌注，每周灌注1次，疗程12~36周，并且于治疗前和随访6个月时行钾离子敏感实验及膀胱镜检查，观察治疗前后患者盆腔疼痛及尿频评分（PUF）、O'Leary-Sant IC问卷表评分（ICSI/ICPI）、膀胱容量测定和生活质量评分（QOL）的变化。结果：60例患者均完成治疗，随访6~32个月，平均16个月，51例患者症状缓解或消失，PUF评分、ICSI/ICPI评分、膀胱容量、QOL评分明显改善，9例患者效果较差。PUF评分治疗前为（21.18±3.26）分，治疗3个月后降为（10.03±3.60）分，治疗6个月后为（12.17±3.46）分；ICSI治疗前为（12.15±2.08）分，治疗3个月后降为（8.58±2.27）分，治疗6个月后为（8.82±2.52）分。ICPI治疗前为（10.59±2.12）分，治疗3个月后为（7.87±2.56）分，治疗6个月后为（7.95±2.28）分。膀胱容量由（128.32±15.35） ml增加为（296.59±81.20） ml，QOL评分治疗前为（22.71±6.35）分，治疗3个月后升为（43.68±7.62）分，治疗6个月后为（58.25±5.26）分，治疗前后比较差异均有统计学意义（P<0.05）。结论：膀胱水扩张联合灌注透明质酸钠能显著改善IC患者的临床症状，提高生活质量，是一种安全有效的治疗方法。
- 间质性膀胱炎 /
- 膀胱水扩张 /
- 透明质酸钠
Abstract: Objective: To discuss the clinical diagnosis and treatment of interstitial cystitis (IC) and evaluate the efficacy of bladder hydrodistention combined with sodium hyaluronate irrigation. Method: The data of 60 IC patients (diagnosed by standards of National Institute of Diabetes and Digestive and Kidney Diseases, NIDDK) from May 2009 to March 2014 were retrospectively analyzed.All patients were received cystoscopic hydrodistention under anesthesia. Bladder irrigation with sodium hyaluronate 40 mg diluted with 50 ml 2-3 days postoperatively once a week for 12-36 weeks and cystoscopy and potassium sensitivity test were performed before and six months after the treatment. The Pelvic Pain, Urgency and Frequency (PUF), O'Leary-Sant IC symptom index and problem index (ICSI/ICPI), the maximum bladder capacity and quality of life (QOL) were observed before and after treatment.Result: No patients withdrawed. All patients were followed up for 6-32 months (mean, 16 months), and 51 patients' symptom relieved. All evaluating indicators including PUF, ICSI/ICPI, the maximum bladder capacity and QOL improved, but nine patients had poor response to this treatment. The results of evaluating indicators were as follows:the PUF reduced from (21.18±3.26) to (10.03±3.60) after three months of treatment and decreased to (12.17±3.46) after six months of therapy; O'Leary-Sant ICSI reduced from (12.15±2.08) to (8.58±2.27) after three months of treatment and decreased to (8.82±2.52) after six months of therapy; ICPI reduced from (10.59±2.12) to (7.87±2.56) after three months of treatment and decreased to (7.95±2.28) after six months of therapy; the maximum bladder capacity increased from (128.32±15.35) ml to (296.59±81.20) ml; QOL increased from (22.71±6.35) to (43.68±7.62) after three months of treatment and increased to (58.25±5.26) after six months of therapy. There were significant improvements in all the above parameters comparing between the baseline and three months or six months after the treatment (P<0.05).Conclusion: The treatment of IC with bladder hydrodistention and sodium hyaluronate irrigation is effective and can significantly relieve clinical symptoms and improve quality of life of patients.
- interstitial cystitis /
- bladder hydrodistention /
- sodium hyaluronate

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