女性膀胱疼痛综合征15例综合治疗初探  

Initial study on a comprehensive strategy for female patients with bladder pain syndrome

作　　者：吴海岐 徐海[2] 伊尔范江·亚力坤 加素尔·巴吐尔 甘营国 谭震宇 陆立 WU Haiqi;XU Hai;YIERFAN Yalikun;JESUR Batur;GAN Yingguo;TAN Zhenyu;LU Li(Department of Rectal Surgery,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,National Key Clinical Specialty,The Sixth Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510655;Department of Urology,The First People s Hospital of Kashgar Prefecture,Kashgar 844000,China)

机构地区：[1]中山大学附属第六医院肛肠外科,广东省盆底疾病重点实验室,国家重点专科,广东广州510655 [2]喀什地区第一人民医院泌尿外科,新疆喀什844000

出　　处：《现代泌尿外科杂志》2023年第2期149-152,共4页Journal of Modern Urology

摘　　要：目的 探讨一种结合膀胱水扩张、膀胱病损电切和三联药物膀胱灌注的综合治疗策略应用于膀胱疼痛综合征(BPS)患者的疗效。方法 纳入2020年1月1日—2021年10月20日喀什地区第一人民医院泌尿外科收治的BPS女性患者共15例。所有患者均行麻醉下膀胱水扩张术和膀胱镜下病损组织电切术,术后予三联药物混合溶液(2%盐酸利多卡因20 mL+肝素钠2.5万U+地塞米松10 mg+0.9%氯化钠注射液稀释至60 mL)膀胱灌注连续5 d,随后每周1次,连续灌注4周。动态评估所有患者疼痛视觉模拟评分(visual analogue scale, VAS)、性生活评分、一般健康状况评分和焦虑评分。比较治疗前及治疗后(1、4、12周)的疗效,记录并发症发生情况。结果 15例患者均完成治疗,与治疗前相比,14例患者治疗后第1、4、12周时的VAS评分、一般健康状况评分和焦虑评分得以改善。1例患者症状无变化。VAS评分由(5.47±1.81)分下降至(1.87±1.51)分(P<0.05),焦虑评分由(18.13±8.64)分下降至(6.33±8.22)分(P<0.05),一般健康状况评分由(24.47±5.41)分上升至(31.53±6.49)分(P<0.05)。结论 综合治疗策略是治疗膀胱疼痛综合征的有效方法,可以缓解疼痛症状和提高生活质量。Objective To explore the efficacy of a comprehensive treatment strategy of bladder hydrodistension, transurethral resection of bladder lesions and triple drug instillation in patients with painful bladder syndrome(BPS).Methods A total of 15 female BPS patients treated during Jan.2020 and Oct.2021 were enrolled.All patients received bladder hydrodistension and transurethral resection.After operation, intravesical instillation of a triple-drug mixture(2% lidocaine hydrochloride 20 mL,heparin sodium 25 000 U,and dexamethasone 10 mg) was administered once a day for 5 days, and then once per week for 4 weeks.The Visual Analogue Scale(VAS) score, quality of sexual life, health-related quality of life, and self-rating anxiety scale score were compared before treatment and 1,4 and 12 weeks after treatment.The complications were recorded.Results All patients completed the treatment.Of 14 patients, the VAS score and self-rating anxiety scale score were lower in week 1,4 and 12 after treatment, while the health-related quality of life score increased.One patient’s symptoms remained unchanged.The VAS score decreased from(5.47±1.81) to(1.87±1.51)(P<0.05),and the self-rating anxiety scale score decreased from(18.13±8.64) to(6.33±8.22)(P<0.05).The score of health-related quality of life increased from(24.47±5.41) to(31.53±6.49)(P<0.05).Conclusion The comprehensive strategy is effective in the treatment of bladder pain syndrome, which can relieve pain symptoms and improve patients’ quality of life.

关 键 词：膀胱疼痛综合征 综合治疗 膀胱水扩张 膀胱内治疗 经尿道电切术 

分 类 号：R694[医药卫生—泌尿科学]