膀胱白斑膀胱镜影像系统显像特点及临床意义

Imaging characteristic and clinical significance of vesical leukoplakia

目的探讨膀胱白斑在膀胱镜影像系统的显像特点及临床意义。方法采用双盲随机法抽取经病理检查确诊的膀胱白斑患者556例，观察膀胱镜影像系统中病变的显像特点。患者均予抗感染治疗1～2周，复查膀胱镜，对比观察治疗前后的变化。结果556例患者膀胱镜显像中膀胱白斑病变呈4种表现，按病情轻到重分别为：充血型42例、斑点型56例、薄斑型399例、厚斑型59例。抗感染治疗后，病变各型可相互转化，其中好转131例、无变化304例、加重121例。统计学分析显示：膀胱白斑4种类型变化比率差异有统计学意义（Χ^2=130．92，ν=6，P〈0．001），从充血型到斑点型、薄斑型、厚斑型，治疗后好转比率有逐渐减少趋势，无明显变化和加重比率有逐渐增多趋势。结论在膀胱镜影像系统中膀胱白斑显像表现可初步分为充血型、斑点型、薄斑型、厚斑型4型，根据分型不同应采取不同的治疗方案。

Objective To study the imaging characteristics of vesical leukoplakia under the cystoscope imaging system. Methods The characteristics of vesical leukoplakia were observed under the cystoscope imaging system in 556 cases. After anti infection treatment to these patients, the changes of the characteristic under the cystoscope imaging system were re-observed and compared before and after treatment. SPSS 11.0 software package Χ^2 test for statistical analysis was used. Results Under the cystoscope imaging system, there were four different imaging manifestations in the 556 patients. These were, from mild to severe, congestive type in 42 cases, spots type in 56 cases, thin macular type in 399 cases and thick macular type in 59 cases. One type could transform to another after anti-infection treatment. When reexamination by the cystoscope, 131 cases got improved,304 cases had no changes and 121 cases were aggravated. Statistical analysis showed the transformation among the 4 types had significant difference （Χ^2 = 130.92, ν = 6, P〈 0. 001）. From congestive type to spots type, thin macular type and thick macular type, after anti-infection treatment, the ratio of improved cases decreased gradually, however the ratio of aggravated cases and cases without changes increased gradually. Conclusion Vesieal leukoplakia could be classified into 4 types initially： congestive type,spots type, thin macular type, thick macular type. The different clinical treatments should be provided.