氯胺酮相关性膀胱炎综合治疗疗效分析  

Curative effect analysis of combined therapy on ketamine associated with cystitis

作　　者：陈深泉[1] 肖剑[1] 杨帝宽 刘明建[1] 吴保忠[1] 

机构地区：[1]广东省肇庆市第二人民医院泌尿外科,526060

出　　处：《中国现代医药杂志》2015年第7期33-35,共3页Modern Medicine Journal of China

摘　　要：目的探讨氯胺酮相关性膀胱炎行综合治疗的临床疗效。方法2011年1月～2015年3月我科收治27例氯胺酮相关性膀胱损害患者，男20例，女7例，23例有明显下尿路症状，2例除有下尿路症状表现还合并耻骨上剧烈疼痛，2例因反复肉眼血尿就诊。27例患者均有氯胺酮滥用病史，病程为8个月～4年。所有患者均停止吸食氯胺酮。此外口服M3受体拮抗剂和／或α1受体阻滞剂药物，并行心理辅导及宣传教育。另选择性行膀胱功能锻炼、药物灌注、膀胱黏膜电灼及水压扩张等综合疗法，并通过O’Leary—SantIC症状评分（ICSI）及问题评分（ICPI）进行疗效评估。结果27例患者经综合治疗后下尿路症状均有不同程度的缓解，治疗后的ICPI评分为（4．7±0．8）分，显著低于治疗前的（11．9±1．1）分，治疗后的ICSI评分为（4．6±0．8）分，显著低于治疗前的（12．9±1．3）分，差异有统计学意义（P〈0．05）。结论氯胺酮相关性膀胱炎最有效的治疗是戒除吸食，心理辅导、药物治疗、膀胱灌注及水压扩张等综合疗法具有良好的治疗效果。Objective To explore the curative effect of ketamine associated with cystitis. Methods 27 cases （20 eases male, 7 cases female） of ketamine associated with bladder damage from Jan 2011 to Mar 2015 in our department, 23 pa- tients had significantly lower urinary tract symptoms,2 cases had lower urinary tract symptoms combined with suprapubic severe pain and 2 eases had naked eye hematuria. All patients had medical history of ketamine abuse, the course of disease was from 8 months to 4 years. All patients stopped abusing ketamine and were treated with oral M3 receptor antagonist and/or αl adreno- eeptor blocker drugs and intervened psychological counseling and education. Bladder function training, drug perfusion, bladder mucosa fulguration and hydraulic expansion therapy were also selected, the efficacy was assessed by the standards of O＇Leary- Sant IC （interstitial cystitis） symptom index （ICSI） and problem index （ICPI）. Results After combined therapy, the lower urinary tract symptoms of 27 cases relieved. ICSI score, ICPI score decreased significantly compared with prior treatment respec- tively[（4.7±0.8） vs （11.9±1.1）, （4.6±0.8） vs（12.9±1.3）]. Conclusion The most effective treatment of ketamine associated with cystitis is getting rid of ketamine, combined therapy is a safe and effective therapy for the treatment of ketamine associated with cystitis.

关 键 词：氯胺酮 膀胱炎 综合治疗 

分 类 号：R694.3[医药卫生—泌尿科学]