间质性膀胱炎／膀胱疼痛综合征水扩张联合不同药物灌注疗效评估

摘要

Objective To explore the efficacy of bladder hydrodistension combined with drug intravesical therapy in treatment of IC/BPS.Methods O’ Leary-Sant questionnaire and PUF were used to assess the patients’ symptoms.Depending on the intravesi-cal drugs, the patients were divided into groups A and B.To group A, hyaluronic acid was administered intravesically; To group B, heparin cocktail was given intravesically.The efficacy was comparied between the two groups before and after treatment.Results Af-ter 6 months of treatment, the total effective rates were 88.6%(group A) and 86.1%(B group) respectively.Comparing the total ef-fective rates of the two groups, there was no statistically significant difference (P=0.074).Compared with before treatment, the ob-served indicators in the two groups of patients were improved(P<0.05) after treatment at 1,3,6 months.1 month after treatment, the difference between the two groups was not significant (P>0.05), 3 months and 6 months after treatment, differences between the two groups were statistically significant(P<0.05).Conclusions Hydrodistension combined with intravesical instillation of hyaluronic acid or heparin cocktail method can effectively alleviate the symptoms of patients with IC/BPS; hyaluronic acid is superior to heparin cocktail method in the long-term efficacy.%目的：探讨间质性膀胱炎／膀胱疼痛综合征患者膀胱水扩张联合不同药物膀胱灌注治疗的疗效。方法回顾性分析2009-11至2012-08共收治的71例IC／BPS患者。其中女59例，男12例。年龄21～76岁，平均（43．0±11．4）岁。病程6～240个月，平均（63．0±62．3）个月。 IC／BPS症状评估采用O＇Leary-Sant调查表和疼痛、尿急、尿频症状评分表（ the pelvic pain and urgen-cy／frequency patient symptom，PUF）。所有患者均行麻醉下膀胱镜检及水扩张。根据灌注药物的不同将患者分为A、B两组，A组行透明质酸钠灌注，B组行肝素钠鸡尾酒法灌注，比较两组间治疗后（1、3、6个月）的疗效。结果治疗后的第6个月A组总有效率为88．6％；B组总有效率为86．1％。两组总有效率相比，差异无统计学意义（P＝0．074）。与治疗前相比，两组患者治疗后第1、3、6个月时的各项观察指标（每日排尿次数、膀胱最大容量、ICSI评分、ICPI评分及PUF评分）均得以改善（P＜0．05）。治疗后1个月两组间各项观察指标比较差异无统计学意义（P＞0．05），治疗后3个月与6个月两组间各项观察指标比较差异均具有统计学意义（P＜0．05）。结论水扩张联合膀胱内透明质酸钠或肝素鸡尾酒法灌注均可有效的缓解IC／BPS患者的症状，而在长期疗效中透明质酸钠优于肝素鸡尾酒法。