女性腺性膀胱炎15年诊疗经验回顾(附458例分析)

Review of diagnosis and treatment for cystitis glandularis in female in last 15 years(a report of 458 cases)

目的为提高对女性腺性膀胱炎的认识和诊疗效果。方法回顾性地报告该院15年来诊疗、随访的女性腺性膀胱炎458例,随访时间为2～15年,平均为8年2个月。对病例的症状、膀胱镜下的表现进行讨论,将所有病例按照治疗方法分为4组:单纯经尿道电灼治疗的6例为A组;单纯经尿道电切的24例为B组;经尿道电切后加塞替派直接经尿道灌注膀胱的66例为C组;经尿道电切后加吡柔比星、异搏定、力尔凡序贯联合灌注膀胱的362例为D组。按治愈、好转、有效、无效和复发的标准统计计算4组的结果,4组的结果作统计学分析。结果A组的症状几乎没有改善;B组的有效率为75%,复发率为25.0%;C组的有效率为90.9%,复发率为9.1%;D组的有效率为93.9%,复发率为4.4%。各组差异有显著性。结论典型的腺性膀胱炎膀胱镜下肉眼基本即能诊断;单纯经尿道电灼治疗的方法不可取;单纯经尿道电切的复发率较高;经尿道电切后塞替派膀胱灌注是治疗女性腺性膀胱炎和预防其复发的简单、便宜、有效的方法;经尿道电切后加吡柔比星、异搏定、力尔凡序贯联合灌注膀胱效果最好,但价钱较贵。

[Objective] To evaluate the procedures of diagnosis and treatment for cystitis glandularis in female. [Methods] 458 female cases of cystitis glandularis diagnosed retrospectively, who have been followed up for 2-15 years with a means of eight years and six months, were studied to discuss the symptom and the feature of eystoscope. According to the treatment procedures, they were divided into four groups： A group： 6 cases treated with transurethral fulguration only; B group：24 cases treated with transurethral resection only; C group： 66 cases treated with transurethral resection and followed bladder instillation of Thio-TEPA; D group： 362 cases treated with transurethral resection and followed bladder instillation with Pirarubicin（THP）, verapamil and lifein sepuence. [Results] The symptom of A group was not improved; The effective rate of group B is 75%, and the recurrence rate is 25.0%, In group C： The effective rate was 90.9%. The recurrence rate was 9.1%. and in group D： The effective rate was 93.9%. The recurrence rate was 4.3%. They were different in statistics. [Conclusions] Typical cystitis glandularis can be diagnosed by cystoscope. For treating and preventing recurrence of cystitis glandularis in female, transurethral fulguration is not effective; transurethral resection followed by bladder instillation with Thio-TEPA is a more effective treatment than transurethral resection only; the best way is transruethral resection followed by bladder instillation with Pirarubicin（THP）, verapamil and lifein sepuence, but the cost is more expensive.