摘要
目的探讨腺性膀胱炎电切术后创面愈合不良的原因。方法 2006年7月至2011年6月,腺性膀胱炎行膀胱黏膜电切术患者87例,术后创面愈合不良4例(4.6%),均为女性。对患者病史、治疗及随访情况进行回顾性分析。结果 4例随访11～58个月,平均28个月。1例有盆腔放疗和糖尿病病史,术后电切创面钙化斑形成,反复出现尿路感染,5年后因出现双侧上尿路积水、膀胱容量变小,行膀胱旷置、双侧输尿管皮肤造口术;1例有糖尿病和急性造血功能停滞病史,术后创面愈合不良,反复出血,经雄激素联合糖皮质激素治疗、造血功能改善后创面疤痕愈合;1例出现创面钙化斑,随访观察,16个月后钙化斑明显减少;1例术后1个月经期前膀胱灌注后出现创缘出血并尿潴留,经电凝止血后5个月创面愈合。随访无一例发生恶变。结论腺性膀胱炎黏膜电切术后创面愈合不良原因不明,盆腔放疗、糖尿病、造血功能异常、丝裂霉素C个体特异反应等可能是相关危险因素。对伴有上述危险因素的腺性膀胱炎患者,选择膀胱黏膜电切术及膀胱灌注化疗时应慎重。
Objective To explore the risk factors of poor wound healing following transurethral elec- troresection in cystitis glandularis （CG）. Methods Transurethral electroresection was performed on a total of 87 cases of CG from July 2006 to June 2011. Four patients （4.6%） had poor wound healing. The history, treatment and results of follow-up were reviewed. Results All four cases were female. A mean follow-up of 28 months （11-58）. One suffered from bladder wall calcification about 5 years, who had history of dia- betes and pelvic irradiation for cervical cancer, and developed a low-compliance small-capacity bladder and bilateral ureteral obstruction. The patient underwent labels for bladder, bilateral ureteral skin creates mouth. One had postoperative recurrent hemorrhage from localized benign inflammatory reaction,who had history of diabetes and acute hematopoiesis function stagnation, and the wound was healing by scar after hematopoiesis function improved with androgen and glucoeorticoid treatment. One had massive calcified de- posits in bladder wall in lesion of previous transurethral resection after a total of 8 intravesical mitomycin C, and the calcified plaque was displaced by mucosa after 16 months.One occurred bleeding at the edge of wound after intravesical mitomycin C and before menstrual period. The wound was healing in 5 months after electric coagulation. No single case ever developed cancer. Conclusion The reasons of poor wound healing following transurethral electroresection in CG is is not clear. History of diabetes,pelvic irradiation, acute hematopoiesis function stagnation and individual specific reaction to mitomycin C could be an important risk factor for this complication. Treating CG with these factors by transurethral electroresection and intrav- esical mitomycin C must be careful.
出处
《中华腔镜泌尿外科杂志（电子版）》
2012年第3期59-61,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
腺性膀胱炎
膀胱黏膜电切术
创面愈合不良
Cystitis glandularis
Transurethral electroresection
Poor wound healing
