氯胺酮相关性膀胱炎的诊断与治疗  

The Diagnosis and Treatment of Ketamine Cystitis

作　　者：卢穗琳[1] 戚德峰[1] 刘冠炤[1] 单炽昌[1] 曾国华[1] 

机构地区：[1]广州医科大学第一附属医院微创外科中心泌尿外科/广东省泌尿外科重点实验室/广州市泌尿外科研究室,广东广州510230

出　　处：《中外医疗》2017年第26期7-9,共3页China & Foreign Medical Treatment

基　　金：[基金项目]粤科规划字(2011)112号

摘　　要：目的探讨氯胺酮(K粉)所引发的以下尿路症状为主要表现的膀胱炎的诊断与治疗。方法方便选取2008年11月—2016年4月因吸食"K粉"导致氯胺酮相关性膀胱炎的患者40例,首先戒断氯胺酮,服用α受体阻滞剂和M受体阻滞剂对症治疗,同时保护肝肾功能,根据膀胱刺激症状和膀胱挛缩的程度采用透明质酸钠膀胱灌注,和(或)麻醉状态下以生理盐水作为灌注液,进行水压扩张膀胱术;灌注前应常规行膀胱黏膜活检;症状严重者可行回肠膀胱扩大术治疗。结果 40例患者经对症治疗后,下尿路刺激症状缓解,其中血尿消失最快最明显,但尿频尿急缓解较慢。随访1年,只有2例患者由于不能完全杜绝K粉的滥用,出现症状反复。结论氯胺酮相关性膀胱炎可能是一种以下尿路刺激症状为主要表现的膀胱功能损害,其病理结构与间质性膀胱炎相类似,运用上述治疗原则处理,治疗效果满意,值得进一步应用和推广。Objective This paper tr ies to inves tig ate th e diagnosis an d tre a tm en t of k e tam in e cy s tit is, which mainly p resen ts lower urinary tract symptom. Methods 4 0 c a se s of k etam in e ab u se rs from November 2 008 to Apr il 2 0 1 6 were convenien t selected. First ly stopping or reducing the abuse of ketamine, and then taking antispasmodic drugs such as 琢- re c e p to r b lo ck -ers and M receptor blocker, liver and modulating kidney function were protected at the same time. Cys tectasia with sodium hyaluronate solution was used to al leviate lower urinary tract syndromes in pat ients with ketamine cys tit is. Saline was used to be ir rigat ing fluid for cystectasia. Bladder biopsy should be performed before the surgery. For those suffering from severe symptoms, ileum augmentation cys toplasty may be necessary. Results After re c e iv in g symptomatic tre a tm en t of th e 4 0 p a -t ients, lower urinary tract symptoms were relieved, including the most apparent and fas test disappearance of hematur ia, while the frequency and urgency of emict ion relieved slowly. Only 2 cases reversed the symptoms af ter fol low-up for one year due to thei r addict ion to ketamine. Conclusion Ketamine as so c iated cy s tit is, s im ila r to interstitial cy s tit is, might beakind of inflammatory process involving the upper and lower urinary tract. Using the above treatment pr inciple, the treatment effect is satisfactory, and it is worth appl icat ion and the promotion.

关 键 词：氯胺酮 药物滥用 尿路炎性损害 诊断与治疗 

分 类 号：R694[医药卫生—泌尿科学]