间质性膀胱炎综合治疗的临床研究  

Clinical study of comprehensive treatment of interstitial cystitis

作　　者：温海东 何问理 林文俊 刘辉 宋少辉 童鹏 苏凯斌 杨俊 吕军 Wen Haidong;He Wenli;Lin Wenjun;Liu Hui;Song Shaohui;Tong Peng;Su Kaibin;Yang Jun;Lyu Jun(Department of Urology,Yuedong Hospital,the Third Affiliated Hospital of Sun Yat-sen University,Meizhou 514021,China)

机构地区：[1]中山大学附属第三医院粤东医院泌尿外科,梅州514021 [2]南部战区总医院泌尿外科,广州510010

出　　处：《新医学》2020年第5期391-395,共5页Journal of New Medicine

摘　　要：目的探讨膀胱内水扩张、肝素-碱化利多卡因膀胱内灌注及心理干预3种方式综合治疗间质性膀胱炎(IC)的临床效果。方法收集接受水扩张、肝素-碱化利多卡因膀胱内灌注联合心理干预治疗的23例IC患者,分别于术前和术后1、6、12个月。采用间质性膀胱炎指数(ICSI)评价患者症状(如尿频、尿急、膀胱/盆腔疼痛或不适情况)的变化,使用尿流动力学检查了解患者膀胱潴尿期的感觉、顺应性、容量及稳定性变化,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者的心理状态变化。结果与治疗前比较,综合治疗1、6、12个月后,23例IC患者的SAS、SDS及ICSI评分均降低(P均<0.008),排尿次数减少(P均> 0.008),初尿感、最大膀胱容量均增加(P均<0.017),且疗效一直维持(治疗后各时点间两两比较P>0.008或0.017)。1例膀胱顺应性下降的患者恢复其顺应性,1例膀胱过度活动的患者未检出膀胱过度活动。结论膀胱内水扩张、肝素-碱化利多卡因膀胱内灌注联合心理干预综合治疗IC的临床效果明显,患者生理及心理状态均有好转。Objective To evaluate the clinical efficacy of internal bladder dilatation, intrabladder perfusion with heparin-alkalized lidocaine in combination with psychological intervention in the comprehensive treatment of interstitial cystitis(IC). Methods Clinical data of 23 patients with IC received the comprehensive treatment before and 1-, 6-and 12-month after surgery were collected. The changes of symptoms(urination frequency, urination urgency, bladder/pelvic pain) were evaluated by interstitial cystitis symptom index(ICSI). The changes(bladder sensation, compliance, capacity and stability) during bladder urine storage period were assessed by urine flow dynamic test. The changes of mental state were evaluated by self-rating anxiety scale(SAS) and self-rating depression scale(SDS). Results At 1-, 6-and 12-month after comprehensive treatment, the SAS, SDS and ICSI of 23 patients were significantly declined, the urination frequency was decreased, the initial urination sensation and the maximum bladder volume were remarkably increased(all P < 0.008). The clinical efficacy was maintained at different time points(P > 0.008 or 0.017 when compared between two time points). One patient with decreased bladder compliance was restored and one case of overactive bladder was recovered. Conclusion The comprehensive treatment of internal bladder dilatation, intrabladder perfusion with heparin-alkalized lidocaine in combination with psychological intervention yields high clinical efficacy for IC, which can mitigate the physiological and psychological state of IC patients.

关 键 词：间质性膀胱炎 水扩张 肝素-碱化利多卡因 心理干预 

分 类 号：R694.3[医药卫生—泌尿科学]