经尿道等离子电切术治疗女性腺性膀胱炎(附97例报告)  

Treatment of cystitis glandularis in female patients by bipolar plasmakinetic resection(Report of 97 Cases)

作　　者：周峰[1] 汪超军[1] 刘犇[1] 罗金旦[1] 郑祥毅[1] 黄啸[1] 金百冶[1] 

机构地区：[1]浙江大学医学院附属第一医院泌尿外科,杭州310003

出　　处：《微创泌尿外科杂志》2014年第4期227-229,共3页Journal of Minimally Invasive Urology

基　　金：浙江省教育厅资助项目(Y201018597)

摘　　要：目的:总结女性腺性膀胱炎的临床特点和治疗方法.方法:对97例腺性膀胱炎患者的临床诊治资料进行回顾分析.97例患者年龄23～79岁,平均49.6岁.主要临床症状:尿频、尿急、尿痛37例,血尿24例,膀胱刺激症状伴血尿12例,下腹痛9例,排尿困难8例,无症状经体检发现3例.反复尿路感染或尿常规、尿培养提示感染45例,合并膀胱颈口抬高14例.先期病变为膀胱移行细胞癌,术后9个月发现腺性膀胱炎2例.所有患者均经膀胱镜活检或手术标本病理检查证实为腺性膀胱炎.结果:病变位于膀胱三角区、膀胱颈口86例,膀胱侧壁3例,后壁6例,顶部2例.病变呈滤泡状41例,乳头状23例,绒毛状12例,炎症改变13例,黏膜无显著改变8例.9例给予保守治疗,4例获得随访,时间为3个月～2年,抗感染治疗后症状缓解;88例行手术治疗,全部行经尿道等离子电切术,70例获得随访,时间为8个月～9年,66例未见复发,4例复发,复发间隔时间:13～20个月,平均15.5个月.复发患者1例保守治疗,未行手术,3例再次给予手术治疗,均再次行经尿道等离子电切术.结论:女性腺性膀胱炎多伴有尿路感染及膀胱颈梗阻,病变多较轻,经尿道等离子电切是简单、有效的治疗方法,预后良好.Objective:To approach the clinical features and treatment of cystitis glandularis in female patients.Methods:A retrospective analysis of clinical data of 97 cases of cystitis glandularis in female patients was made.Their age ranged from 23 to 79years and the mean age was 49.6years.Frequency,urgency and dysuria were observed in 37 patients hematuria in 24,irritation sign of bladder and hematuria in 12,lower abdominal pain in 9,difficulty of urination in 8and asymptomatic in 3.Urinary tract infection in 45 patients and bladder neck obstruction in14.2patients were diagnosed with cystitis glandularis at 9 months after surgical treatment of bladder cancer.Results:The lesions were located at the trigone and bladder neck in 86 cases,at lateral wall of bladder in 3cases,at posterior wall in 6cases and at apex of bladder in 2cases.The lesions were follicular in 41 cases,papillar in 23 cases,villiform in 12 cases,chronic inflammation type in 13 cases and unchanged mucosa type in 8cases.Of the 97 cases,9were treated conservatively,4cases were followed up of 3-24 months,and their symptoms were remitted.88 cases underwent surgery,including 88 cases for transurethral resection.70 cases were followed up of 8 months-9years,66 were not recurrent,4were recurrent at 13 to 20months(mean 15.5months)postoperatively.1case of recurrent patient was treated conservatively,3for transurethral resection.Conclusions:Urinary tract infection and bladder neck obstruction are very common in female patients of cystitis glandularis.Transurethral recection of the lesion is a simple and effective therapy,with favorable outcome at long-term follow-up.

关 键 词：膀胱炎 女性 治疗 

分 类 号：R694[医药卫生—泌尿科学]