经尿道电切联合膀胱内灌注羟基喜树碱治疗腺性膀胱炎

Transurethral resection combining with intravesical instillation of hydroxycamptothecin for the treatment of cystitis glandularis

目的评价经尿道电切联合膀胱内灌注羟基喜树碱治疗腺性膀胱炎的疗效。方法腺性膀胱炎患者25例。男10例,女15例。年龄25～71岁,平均43岁。临床症状主要表现为尿频、尿急,伴血尿8例,排尿困难者4例,8例伴有不同程度的下腹部隐痛、不适。25例患者均行膀胱镜检查及组织活检证实为腺性膀胱炎。采用硬膜外麻醉下经尿道病变组织电切,术后1周开始膀胱灌注羟基喜树碱20mg+生理盐水50mL,保留2h,每周1次,连续8次,之后每月1次至术后2年。结果25例均获随访,时间6～38个月,平均24个月。20例治愈,4例好转,1例无效,其中1例术后3个月复发,25例均无恶变。结论经尿道电切联合术后膀胱灌注羟基喜树碱可显著改善腺性膀胱炎症状,是一种有效可行的治疗方法。

[Objective] To evaluate the efficacy of intravesical hydroxycamptothecin combining with TUR therapy for cystitis glandularis. [Methods] The clinical data of 25 patients （male 10, femal 15） with cystitis glandularis were analyzed. The mean age is 43 years （range 25-71 years）. The main clinical symptoms include urinary frequency, urgency, hematuria in 8 cases, vague pain or indisposition in 8 cases, dysuresia in 4 cases, cystitis glandnlaris was confirmed by cystoscopy and biopsy. TUR was performed under CEA. Hydroxycamptothecin were given by irrigation of bladder after operation, 1 time per week for 8 weeks, then 1 time per month to 2 years. [Results] The 25 cases were followed up for 6 to 38 months （mean, 6 months） after treatment. 20 patients cured well, 4 patients obtained symptom relief, but 1 cases failed to respond to treatment, 1 case had recurrence 3 months after operation, no canceration in all cases during follow-up. [Conclusions] Combining of TUR and intravesical hydroxycamptothecin therapy may relieve symptoms and maybe effective against local recurrence of cystitis glandularis.