腺性膀胱炎的诊治(附65例报告)

Diagnosis and Treatment of Cystitis Glandularis:a Report of 65 Cases

目的：探讨腺性膀胱炎的诊断和治疗。方法：对65例腺性膀胱炎患者临床资料进行分析。膀胱肿瘤术后常规复查发现者15例；置双“J”管后5例；反复尿路感染者21例；肉眼血尿或镜下血尿6例；排尿困难7例；下腹部痛11例。伴发膀胱腺癌2例,并发膀胱结石6例。38例经尿道电切病变加药物灌注；6例伴有肾积水无法插入输尿管导管者行膀胱部分切除,输尿管口移植术；3例巨大膀胱结石行膀胱部分切除+取石术；5例患者拔除双“J”管；11例仅行膀胱灌注治疗；2例伴发膀胱肿瘤患者行膀胱部分切除术。结果：52例获得随访,随访时间1～9年。经尿道电切组22例症状缓解,随访膀胱镜查6例复发；开放手术组症状均缓解,膀胱镜检查1例复发；双“J”管拔除后3个月后3例患者病变消失；单纯药物灌注组5例症状缓解,膀胱镜检查4例病变程度减轻,7例病变无明显变化。结论：腺性膀胱炎在确证后应积极治疗,在治疗时应积极去除诱因,经尿道膀胱病变电切是腺性膀胱炎的有效治疗方法。

Objective：To discuss the diagnosis and treatment of cystitis glandularis. Methods： 65 cases of cystitis glandularis were analyzed retrospectively, 15 cases were found in the routine examination after the operation of bladder tumor. 5 cases occurred after use double ＂J＂. 7 cases complained of dysuresia, Urinary tract infection was found in 21 cases. Bladder stone were found in 6 cases and adenocarcinoma of bladder was found in 2 cases. Transurethral resection and instillation of bladder were performed in 38 cases. Partial resection of bladder and transplantation of ureteric orifice were performed in 6 cases because the ureteral catheter couldn＇t be inserted in the ureter. Instillation of bladder was performed in 11 cases. Partial resection of bladder was performed in the case of adenocarcinoma of bladder. Results： 52 cases were followed up for 1 9 years. The symptoms relieved in 22 cases and recurred in 6 cases of cystoscope in transurethral resection group. The symptoms relieved in all cases and recurred in 1 cases of cystoscope in operative group. In instillation group, the symptoms relieved in 5 cases and the lesion relieved in 4 cases of cystoscope. Conclusion： Cystitis glandularis should be treated actively because of its possibility of development to carcinoma. Etiological treatment is necessary in treatment. Transurethral resection is an effective method in treatment of cystitis glandularis.