经尿道电切气化与丝裂霉素膀胱灌注联合治疗腺性膀胱炎

摘要

Objective To review experience of the diagnosis and therapeutic effect of transurethral electro-resection and electro-vaporization combined with mitomysin bladder instillation in the treatment of cystitis glandularis.Methods One hundred and sixteen cases of cystitis glandularis aged 25 to 75 years(average 48years)were applied with anti-infection,transurethral electro-resection and electro-vaporization,and mitomysin bladder instillation,and their clinical data was analyzed retrospectively.Ninety-eight cases were applied with transurethral electro-resection and electro -vaporization,among whom 21 cases with vesical neck plump or lower lip increase simultaneously underwent transurethral resection of bladder neck,and two cases suspected to be malignant underwent bladder incision and electro-resection and electro-vaporization.Sixteen cases who refused surgical operation and seventeen cases without clear symptom re-mission were given systematic anti-inflammation as well as mitomysin bladder instillation.Results All patients were given 9 to 54 months follow-up.The 98 cases applied with transurethral electro-resection showed normal in cystoscopy.Sixty-eight had their symptoms disappear,the cure rate being 69 ％.Among the 33 cases who were applied with systematic anti-inflammation and mitomysin instillation,18 had their symptoms disappear and reduce,the efficacy rate being 54.5 ％.Conclusion Lower urinary obstruction is the potential etiological factor of cystitis glandularis.The mitomysin bladder instillation and transurethral electro-resection with electro-vaporization is the main method.Systematic anti-inflammation and mitomysin bladder instillation is effective in treating cystitis glandularis.%目的 回顾与总结经尿道电切气化与丝裂霉素膀胱灌注联合治疗腺性膀胱炎的经验和体会.方法 对116例腺性膀胱炎患者行抗感染、经尿道电切加气化、丝裂霉素膀胱药物灌注等治疗,并对其临床资料进行回顾分析.98例采用经尿道电切加电气化治疗,对其中21例合并膀胱颈肥厚或下唇抬高者同时行膀胱颈部电切；2例疑有恶变者行膀胱切开电切加气化治疗；16例拒绝手术者和17例症状缓解不明显者,行全身抗炎及膀胱灌注丝裂霉素等治疗.结果 116例患者随访9～54个月.经尿道电切治疗者98例,膀胱镜检查正常、症状消失者68例,治愈率69％；行全身抗炎及丝裂霉素等灌注治疗者33例,18例症状消失或缓解,有效率54.5％.结论 下尿路梗阻可能是引起腺性膀胱炎的病因,经尿道电切加气化治疗是治疗腺性膀胱炎的主要方法,而全身抗炎、丝裂霉素膀胱灌注是治疗腺性膀胱炎的有效方法.