目的 探讨间质性膀胱炎/膀胱疼痛综合征患者膀胱水扩张联合不同药物膀胱灌注治疗的疗效。方法 回顾性分析2009-11至2012-08共收治的71例IC/BPS患者。其中女59例,男12例。年龄21～76岁,平均(43.0±11.4)岁。病程6～240个月,平均(63.0±62.3)个月。IC/BPS症状评估采用O'Leary-Sant调查表和疼痛、尿急、尿频症状评分表(the pelvic pain and urgen-cy/frequency patient symptom,PUF)。所有患者均行麻醉下膀胱镜检及水扩张。根据灌注药物的不同将患者分为A、B两组,A组行透明质酸钠灌注,B组行肝素钠鸡尾酒法灌注,比较两组间治疗后(1、3、6个月)的疗效。结果 治疗后的第6个月A组总有效率为88.6%;B组总有效率为86.1%。两组总有效率相比,差异无统计学意义(P=0.074)。与治疗前相比,两组患者治疗后第1、3、6个月时的各项观察指标(每日排尿次数、膀胱最大容量、ICSI评分、ICPI评分及PUF评分)均得以改善(P<0.05)。治疗后1个月两组间各项观察指标比较差异无统计学意义(P>0.05),治疗后3个月与6个月两组间各项观察指标比较差异均具有统计学意义(P<0.05)。结论 水扩张联合膀胱内透明质酸钠或肝素鸡尾酒法灌注均可有效的缓解IC/BPS患者的症状,而在长期疗效中透明质酸钠优于肝素鸡尾酒法。
Abstract
Objective To explore the efficacy of bladder hydrodistension combined with drug intravesical therapy in treatment of IC/BPS. Methods O’ Leary-Sant questionnaire and PUF were used to assess the patients’ symptoms. Depending on the intravesical drugs, the patients were divided into groups A and B. To group A, hyaluronic acid was administered intravesically; To group B, heparin cocktail was given intravesically. The efficacy was comparied between the two groups before and after treatment. Results After 6 months of treatment, the total effective rates were 88.6%(group A) and 86.1%(B group) respectively.Comparing the total effective rates of the two groups, there was no statistically significant difference (P=0.074). Compared with before treatment, the observed indicators in the two groups of patients were improved(P<0.05) after treatment at 1,3,6 months. 1 month after treatment, the difference between the two groups was not significant (P>0.05), 3 months and 6 months after treatment, differences between the two groups were statistically significant(P<0.05). Conclusions Hydrodistension combined with intravesical instillation of hyaluronic acid or heparin cocktail method can effectively alleviate the symptoms of patients with IC/BPS; hyaluronic acid is superior to heparin cocktail method in the long-term efficacy.
关键词
间质性膀胱炎/膀胱疼痛综合征 /
水扩张 /
膀胱灌注
Key words
interstitial cystitis/bladder pain syndrome /
hydrodistension /
intravesical instillation
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