地塞米松联合碱化利多卡因膀胱灌注治疗氯胺酮相关性膀胱炎的疗效观察  

Therapeutic efficacy on the treatment of ketamine-related cystitis by vesicoclysis with dexamethasone combined with alkalized lidocaine

作　　者：李亚县[1] 张凯忠[1] 唐志忠[1] 吴爱明[1] 池月英[1] 黎志钦[1] 周立[1] 曾嘉庆[1] 

机构地区：[1]茂名市人民医院泌尿外科,广东茂名525000

出　　处：《岭南现代临床外科》2013年第5期437-439,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的观察地塞米松联合碱化利多卡因膀胱灌注治疗氯胺酮相关性膀胱炎的疗效。方法8例确诊为氯胺酮相关性膀胱炎经戒断吸食氯胺酮、抗生素治疗等常规治疗无效,而拒绝行膀胱水灌注及注射肉毒素的男性患者,用地塞米松及碱化利多卡因行规律膀胱灌注,比较治疗前及治疗1周及3周后患者的排尿情况、OABSS评分等症状改善情况。结果 8例患者经治疗后症状明显改善,排尿日记显示治疗1周后患者日间排尿次数由(20.5±7.8)次减至(5.6±2.3)次(P<0.05),夜间排尿次数由(15.5±3.2)次减少至(3±1.2)次(P<0.05),尿量由(30.4±12.4)mL/次增加至(50±10.1)mL/次(P<0.05)。OABSS评分由治疗前的(10.7±1.5)分减至治疗后的(5.2±1.3)分(P<0.05)。8例患者均未出现药物不良反应。结论地塞米松联合碱化利多卡因膀胱灌注治疗氯胺酮相关性膀胱炎安全、药物普及且费用低,在短期内是有效的,对拒绝行手术治疗的患者,可考虑使用。Objective To observe the treatment efficacy of of ketamine-related cystitis by vesicoclysis with dexamethasone and alkalinized lidocaine. Methods Eight male patients with ketamine- related cystitis, who failed to routine treatment with withdrawal ketamine, antibiotics, tolterodine, alfuzosin, were enrolled in this study. The patients were treated by regular vesicoclysis with dexamethasone and alkalinized lidocaine for 6 weeks, then recorded the therapeutic effect by voiding diary and OABSS in 1-3 weeks after stopping treatment. Results Eight patients made significant improvement after 6 weeks treatment. The frequency of daytime and nocturia mieturition decreased from 20.5±7.8 to 5.6±2.3 and from 15.5±3.2 to 3±1.2 respeetively （P〈0.05）, the urine volume increased from 30.4±12.4 mL to 50±10.1 mL （P〈0.05）, the OABSS deereased from 10.7±1.5 to 5.2±1.3 （P〈 0.05）. All the patients had no adverse drug reactions. Conclusion The treatment of ketamine-related cystitis by vesicoclysis with dexamethasone and alkalinized lidoeaine proved safe and feasible in a short term, and the drugs are popular and low-cost. So it is advised to use for patients who refuse surgical treatment.

关 键 词：氯胺酮相关性膀胱炎 地塞米松 利多卡因 

分 类 号：R694.3[医药卫生—泌尿科学]