摘要
目的探讨间质性膀胱炎(IC)的诊断和治疗。方法对3例依据NIDDK诊断标准确诊的女性间质性膀胱炎患者采取治疗性水扩张/膀胱灌注利多卡因、肝素钠和碳酸氢钠混合液等治疗,总结该病特点、诊断方法及治疗效果。结果 3例患者均为中年女性,临床表现为尿频、尿急、夜尿增多和(或)盆腔疼痛,病程1年以上,患者盆腔疼痛和尿频/尿急症状评分(PUF)≥15,尿检、尿培养、尿沉渣、尿脱落细胞及泌尿系B超等均无异常。膀胱镜检1例有溃疡出血,2例在水扩张后见膀胱壁点状出血,每个区域超过10个;病理示黏膜上皮下间质急慢性炎细胞浸润,血管、淋巴管扩张。联合保守治疗后3例均显著改善症状,PUF评分下降>50%,提高生活质量。结论膀胱内灌注利多卡因、碳酸氢钠和肝素混合液3个月以上配合治疗性膀胱水扩张,排尿间隔时间延长,功能性膀胱容量增加。膀胱灌注"治疗性鸡尾酒"辅以膀胱水扩张治疗IC疗效明显。
Objective To discuss the diagnosis and treatment of interstitial cystitis.Methods A total of 3 female cases that were diagnosed as interstitial cystitis based on the NIDDK standards were poured with the mixed liquor of lidocaine,heparin and bicarbonate and bladder hydrodistention,etc.using non-operation methods,then summarizing the characteristics,method for diagnosis and treatment effects.Results The 3 patients were all middle-aged women,with clinical symptoms as urine frequency and urgency of urination,increased nocturia and/or chronic pelvis pain,for disease course at least one year.The pelvis pain and frequency/urgency symptom score（PUF） ≥15.After cyscytoscopic examination,1 case showed bladder ulcer bleeding,2 cases showed bladder spotting bleeding,each region more than ten,biopsy pathological examination showed that there were acute and chronic inflammatory cells infiltration the mucoca subcutaneous stroma,vessels and lymph vessels were expanding.United conservative management,3 cases had been improved remarkably,PUF rating decreasing more than 50% and the quality of life had been increased.Conclusion Pouring the bladder with the mixed liquor of lidocaine,heparin and bicarbonate for more than 3 months united with the expansion of the bladder,then the intervals of urination increased,and the functional capacity increased.Irrigationing the bladder with ＇cocktail＇ united the treatment of the bladder expansion in interstitial cystitis has a remarkable effect and deserve promotion.
出处
《安徽医学》
2011年第3期304-306,共3页
Anhui Medical Journal
关键词
膀胱炎
间质性
诊断
治疗
Cystitis
Interstitial
Diagnostic
Treatment
