小儿嗜酸性膀胱炎临床分析  

Eosinophilic cystitis in children:a report of six cases and review of literature

作　　者：蔡冰[1] 谢华[1] 徐卯升[1] 耿红全[1] 张忠德[1] 李衷初[1] 刘国华[1] 陈方[1] 

机构地区：[1]上海第二医科大学附属新华医院泌尿外科

出　　处：《中华医学杂志》2003年第20期1791-1794,共4页National Medical Journal of China

摘　　要：目的　探讨嗜酸性膀胱炎的临床表现和诊治方法。方法　对上海第二医科大学附属新华医院于 1998～ 2 0 0 3年收治的嗜酸性膀胱炎患儿 6例进行临床分析并结合文献复习。 6例患儿平均 8.3岁 ,表现为尿频、尿急 ,排尿困难 ,遗尿及间歇性血尿 ,腹痛。影像学检查示膀胱壁增厚和占位性病变。均在膀胱镜下或开放手术 ,组织活检后诊断为嗜酸性膀胱炎。患儿分别接受自体膀胱扩大术 ,膀胱肿块切除术和单纯口服泼尼松、抗生素治疗。结果　 5例患儿随访 5～ 2 8个月 ,排尿异常症状消失 ,影像学检查无膀胱占位性病变。结论　嗜酸性膀胱炎诊断主要依靠膀胱镜下病变组织活检。从病例分析及文献回顾来看 ,治疗应以药物保守为主。手术只在病变难以控制时考虑。Objective Eosinophilic cystitis is a very rare tumor-like inflammatory disease especially in children. It can involve any portion of the bladder and interfere with its function. Here we present 6 pediatric cases and review the literature. Methods Six children, with mean age of 8.3 years, were referred to our clinic. Their major complaints included voiding urgency, frequency, dysuria, enuresis, intermittent hematuria and abdominal pain. Ultrasound, CT scan and voiding cystourethrogram (VCUG) showed diffuse thickening of bladder wall and a filling-defect lesion. They all suggested the possibility of bladder tumor. The final diagnosis of eosinophilic cystitis was made by cystoscopic tissue biopsy or open surgery. Patients underwent bladder autoaugmentation, mass resection or mere oral administration of corticosteroid and antibiotics respectively. Results 5 among 6 patients were followed up for 5～28 months. Their voiding complaints and image changes gradually disappeared. Up to now, there is no relapse. Conclusions The clinical presentation of eosinophilic cystitis includes irritative voiding symptoms, hematuria and abdominal pain. Tumor-like changes could be found in the imagination examinations. A biopsy is mandatory to establish the diagnosis. Treatment in general varies from the removal of the antigenic stimulus, if identifiable, to administration of corticosteroid and antibiotics. When patients fail to respond to the medication treatment, the opening operation could be required.

关 键 词：小儿 嗜酸性膀胱炎 临床分析 诊断 治疗 

分 类 号：R726.91[医药卫生—儿科]