膀胱灌注透明质酸钠联合膀胱区极超短波照射在非细菌性膀胱炎中的疗效研究  

Effect of bladder perfusion with sodium hyaluronate combined with ultrashort wave in treatment of non-bacterial cystitis

作　　者：倪永梁[1] 王海新[1] 焦守镔[1] 杨义[2] 周强[3] 刘希高[4] 史本康[4] Ni Yongliang;Wang Haixin;Jiao Shoubin;Yang Yi;Zhou Qiang;Liu Xigao;Shi Benkang(Department of Urology,Yankuang Group General Hospital,Zoucheng 273500,China;Department of Pathology,Yankuang Group General Hospital,Zoucheng 273500,China;Medical Department,Yankuang Group General Hospital,Zoucheng 273500,China;Department of Urology,Shandong University Qilu Hospital,Jinan 250012,China)

机构地区：[1]兖矿集团总医院泌尿外科,山东邹城250014 [2]兖矿集团总医院病理科,山东邹城250014 [3]兖矿集团总医院医务科,山东邹城250014 [4]山东大学齐鲁医院泌尿外科,济南250012

出　　处：《中华腔镜泌尿外科杂志（电子版）》2018年第5期318-323,共6页Chinese Journal of Endourology(Electronic Edition)

基　　金：兖矿集团2015年重大科研项目(YK2015A017)

摘　　要：目的评价膀胱灌注透明质酸钠联合膀胱区极超短波照射在治疗非细菌性膀胱炎中的疗效。方法选取兖矿集团总医院2013年3月至2016年6月诊断为非细菌性膀胱炎患者46例,按照治疗方式分为三组,对照组18例,采用膀胱灌注自配混合液(地塞米松+糜蛋白酶+利多卡因+无菌注射用水);实验一组13例,采用膀胱灌注透明质酸钠液联合膀胱区极超短波照射;实验二组15例,采用单纯膀胱灌注透明质酸钠液。灌注疗程均为每周一次共12次,其后每2周1次,共6次。治疗前、治疗3个月、治疗结束后复查膀胱镜,在病变区行大体观拍照并取活检行HE染色,在治疗前、治疗3个月及疗程结束后分别进行问卷调查记录盆腔疼痛+尿频/尿急症状评分(PUF评分)、膀胱镜及HE染色淋巴细胞计算膀胱炎组织学评分、排尿日记计算日排尿次数及最大膀胱容量,记录治疗期间的不良反应,观察并分析三组患者的数据变化。结果 45例随访至6个月,实验二组1例因连续2次灌注后出现皮肤瘙痒而中断治疗。疗程结束后,实验一组和实验二组的PUF评分、膀胱炎组织学评分、日排尿次数及最大膀胱容积等指标与治疗前相比,差异有统计学意义(P<0.05),与同期对照组相比差异亦有统计学意义(P<0.05)。疗程结束后,实验一组与实验二组的上述评价指标的差异没有统计学意义,但在治疗中期,实验一组的上述指标要好于实验二组,差异有统计学意义(P<0.05)。治疗期间无严重不良反应。结论膀胱灌注透明质酸钠联合膀胱区极超短波照射治疗非细菌性膀胱炎疗效明确,无严重并发症。相比单纯灌注透明质酸钠,透明质酸钠联合极超短波治疗能更快的改善症状和炎症程度,为非细菌性膀胱炎的综合治疗提供了新的思路,开拓了新的空间。Objective To evaluate the efficacy of bladder perfusion with sodium hyaluronate combined with ultrashort wave irradiation in bladder region in treatment of non-bacterial cystitis.Methods Altogether 46 patients who were diagnosed as non-bacterial cystitis in our hospital from March 2013 to June 2016 were divided into three groups according to different treatment methods:18 patients who accepted bladder perfusion with mixed liquid[dexamethasone+chymotrypsin+lidocaine+SWFI(Sterile Water for Injection)]were classified as Control Group;13 patients who accepted bladder perfusion with sodium hyaluronate solution and ultra-shortwave radiation in the bladder area were classified as Experiment A Group;15 patients who simply accepted intravesical instillation of sodium hyaluronate were classified as Experiment B Group.All the patients underwent the same course of instillation treatment(once a week for 12 times and then once every two weeks for 6 times)and accepted cystoscopy re-examinations before treatment,during 3-month treatment and after treatment.In the lesion area,the general view was adopted to take photos and the biopsy was performed for HE staining.Questionnaires were made before treatment,during 3-month treatment and after treatment respectively,to record pelvic pain+urgency/frequency symptom score(PUF score),cystoscopy,HE-stained lymphocytes for calculation of the histological score of cystitis,micturition diary for calculation of the frequency of daily micturition and maximum bladder capacity,as well as intra-treatment adverse reactions.Data changes of three groups were also observed and analyzed.Results Among all the cases,45 cases were followed up for 6 months,while,the treatment for 1 patient in Experiment B Group was discontinued due to itchy skin after two continuous perfusions.The post-treatment indexes of Experiment A Group and Experiment B Group such as the PUF score,the histological score of cystitis,the frequency of daily micturition and maximum bladder capacity had statistically significant difference

关 键 词：透明质酸钠 极超短波照射 膀胱灌注 非细菌性膀胱炎 疗效 

分 类 号：R694.3[医药卫生—泌尿科学]