经尿道膀胱黏膜电切术联合膀胱颈电切术治疗腺性膀胱炎的临床分析  

Clinical analysis on transurethral electro-resection of bladder mucosa combined with electro-resection of bladder neck for the treatment of female cystitis glandularis

作　　者：卞军[1] 杨建昆[1] 刘存东[1] 周其赵[1] 李峰[1] 薛康颐[1] 袁小旭[2] 戴宇平[2] 

机构地区：[1]南方医科大学第三附属医院泌尿外科,广州510630 [2]中山大学附属第一医院泌尿外科

出　　处：《临床泌尿外科杂志》2013年第10期752-754,共3页Journal of Clinical Urology

基　　金：广东省医学科研基金资助项目(编号A2010360)

摘　　要：目的:研究经尿道膀胱黏膜电切术联合膀胱颈电切术治疗女性腺性膀胱炎的临床疗效。方法:对64例女性腺性膀胱炎患者随机平均分为研究组、对照组,研究组行经尿道膀胱黏膜电切术,术中同时行膀胱颈电切术,对照组仅行经尿道膀胱黏膜电切术,术后两组均以盐酸吡柔比星行膀胱药物灌注治疗。术前、术后3个月进行下尿路症状(LUTS)评分、最大尿流率(Qmax)测定并比较,另行膀胱镜检查及病理活检,以评估治疗效果。结果:两组患者术后3个月LUTS评分较术前均显著下降(P<0.05),研究组患者术后3个月LUTS评分较对照组下降更显著(P<0.05),示研究组下尿路症状改善更明显。研究组患者术后3个月Qmax较术前显著升高(P<0.05),对照组患者术后3个月Qmax较术前无明显改变(P>0.05),研究组患者术后3个月Qmax较对照组更高,差异有统计学意义(P<0.05)。两组患者术后3个月行膀胱镜检查及病理活检均未见腺性膀胱炎复发,均无尿失禁、排尿困难等并发症。结论:经尿道膀胱黏膜电切术联合膀胱颈电切术较单纯行经尿道膀胱黏膜电切术治疗女性腺性膀胱炎的疗效更好。Objective： To analyze the outcome of transurethral eclectro-resection of bladder mueosa combined with electro-resection of bladder neck for the treatment of female cystitis glandularis. Method： Sixty-four female patients with cystitis glandularis were randomly divided into the trial group （n = 32） and the control group （n = 32）, both treated by transurethral electro-resection of bladder mucosa and the former combined with electro-resec- tion of bladder neck, and both treated by intravesical instillation of pirarubicin after operation. Lower urinary tract symptoms score, maximum flow rate and cystoscopy were performed pre-operatively and at three months post-op eratively to evaluate the efficacy of the two groups. Result： Compared with those before operation, lower urinary traet symptoms score at three months after operation declined significantly （P〈0.05）. While lower urinary tract symptoms seore of the trial group at three months after operation was less than those of the control group （P〈0. 05）. Compared with those before operation, the maximum flow rate of the trial group at three months after opera- tion increased significantly （P〈O. 05）, while there is no significant difference in the maximum flow rate of the control group between pre-operation and at three months after operation （P〉0. 05）. While the maximum flow rate of the trial group at three months after operation was higher than those of the control group （P〈0.0.5）. No recurrence of cystitis glandularis was found in the two groups at three months post-operatively. No significant uri nary incontinence and difficult urination was found in the two groups at three months post-operatively. Conclusion： Transurethral electro-resection of bladder mucosa combined with electro-resection of bladder neck for the treatment of female cystitis glandularis is more effective than transurethral electro-resection of bladder mucosa alone.

关 键 词：腺性膀胱炎 治疗 膀胱黏膜切除 膀胱颈 

分 类 号：R694.3[医药卫生—泌尿科学]