间质性膀胱炎的诊断和治疗探讨  

The study of diagnosis and treatment of interstitial cystitis

作　　者：孙忠全[1] 钱伟庆[1] 谢旦生[1] 宋建达[1] 

机构地区：[1]华东医院泌尿外科,上海200040

出　　处：《中华外科杂志》2005年第10期659-661,共3页Chinese Journal of Surgery

摘　　要：目的探讨间质性膀胱炎的诊断与治疗。方法回顾性分析2002年7月—2004年6月诊治的10例间质性膀胱炎患者的临床资料。患者均为女性。平均年龄41岁;平均病程3.4年。符合美国国立糖尿病、消化和肾脏疾病学会间质性膀胱炎诊断标准。均行钾离子敏感试验,8例呈阳性反应。O′Leary Sant间质性膀胱炎症状评分9～20分,平均(14±4)分。所有病人首先行治疗性水扩张,1个月后评价疗效,对疗效不佳和水扩张后复发者行其他治疗。结果10例平均随访7.8个月。水扩张后1个月症状评分降至4～19分,平均(11±6)分,治疗前后比较,差异有统计学意义(t=4.394,P<0.05)。症状显著缓解2例,评分下降>7分;部分缓解3例,评分下降>3分。无效5例。有效率50%。结论钾离子敏感试验在间质性膀胱炎患者中有较高的阳性率。治疗性水扩张可作为首选的治疗方法。Objective To discuss the diagnosis and treatment interstitial cystitis (IC). Methods(The clinical date) of 10 cases of IC (all women) were analyzed. Their age ranged from 31 to 63 years, with a mean of 41 years. Their courses ranged from 1.5 to 7 years, with a mean of 3.4 years. The symptom criteria of the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) was met for IC and no patients had Hunner′s ulcer. Potassium sensitivity tests (PST) were performed in all cases. Eight were positive. The O′Leary-Sant Interstitial Cystitis Symptom Index (ICSI) was used as treatment outcome measures. ICSI score was from 9 to 20 (mean, 14±4) at baseline. All the patients were treated with hydrodistention initially. Efficacy was evaluated at 1 month after hydrodistention. The patients who failed to respond to the treatment and recurrence after the treatment were treated by oral or intravesical therapy.(Results The 10 cases) were followed up for 3 to 26 months (mean , 7.8 months) after hydrodistention. Five patients obtained symptom relief. Among them, symptom significantly relieved or disappeared in 2, with the score decreased >7; symptofm partially relieved in 3, with the score decreased >3. Five cases failed to respond to the treatment. Two cases had recurrence 3 and 6 months after the treatment. The effective rate was 50%. The ICSI score was decreased to 11±6 at 1 month (t=4.394, P<0.05)after the treatment. Those who failed to respond or recurrence after hydrodistention were treated by other methods. Two case were treated with oral Pentosan Polysulfate, effective. Three cases were treated with amitriptylin, 2 effective. Three cases were treated with intravesical Dimethyl sulfoxide plus heparin plus dexamethasone, all effective.(Conclusions The) diagnosis of IC should meet the symptom criteria of the NIDDK. PST has significant high positive rate in IC patient, which can be used not only for diagnosis but also for instruction. There are a lot of strategies in the management of patients with IC. Hydrodis

关 键 词：间质性膀胱炎 诊断和治疗 2004年6月 2002年7月 敏感试验 症状评分 诊断与治疗 回顾性分析 临床资料 平均年龄 诊断标准 肾脏疾病 阳性反应 疗效不佳 治疗前后 治疗方法 钾离子 治疗性 扩张 患者 糖尿病 统计学 有效率 

分 类 号：R694.3[医药卫生—泌尿科学] R697.33[医药卫生—外科学]