上尿路梗阻与伴发慢性膀胱炎的相关性临床研究

Clinical Investigation on the Relationship between Upper Urinary Tract Obstruction and the Accompanied Chronic Cystitis

目的:探讨上尿路梗阻与伴发慢性膀胱炎之间的相关性。方法:通过尿液细菌培养、膀胱镜和输尿管镜检查,对350例上尿路梗阻患者进行前瞻性研究。结果:350例上尿路梗阻中,75例(21.43%)伴发慢性膀胱炎;254例肾盂、输尿管结石性上尿路梗阻中,伴有慢性膀胱炎51例(20.08%);96例其他原因上尿路梗阻中,伴有慢性膀胱炎24例(25.00%)(P>0.05)。在75例慢性膀胱炎中,非细菌性膀胱炎58例(58/350,16.57%),其中腺性膀胱炎38例(10.86%),膀胱白斑病11例(3.14%),增生性膀胱炎9例(2.57%)。58例上尿路梗阻伴发慢性非细菌性膀胱炎中,6例(10.34%)尿液细菌培养阳性;275例不伴有膀胱炎中,27例(9.82%)尿液细菌培养阳性(P>0.05)。16例上尿路梗阻伴有慢性非细菌性膀胱炎患者获术后随访,其中10例膀胱病灶区炎症消失。但其他6例炎症仍较严重而需进一步治疗。结论:上尿路梗阻与伴发慢性膀胱炎之间具有相关性,长期上尿路梗阻可诱发慢性非细菌性膀胱炎的发生,其发病机制需进一步深入研究。

Objective：To explore the relationship between upper urinary tract obstruction and the accompanied chronic cystitis. Methods：The prospective study was carried out in 350 patients with upper urinary tract obstruction. They were inspected by urinary bacterial culture, cystoscopy and ureteroscopcy. Results：In 350 cases of upper urinary tract obstruction, 75 （21.43%） cases were accompanied with visible chronic cystitis. Fifty-one （20. 080/00 ） cases were accompanied with chronic cystitis in 254 cases of upper urinary tract obstruction induced by renal and ureteral stone, and 24 （25.00%） cases were accompanied with chronic cystitis in 96 cases by other factors（P〉0.05）. Fifty-eight （58/350, 16.57%） cases were chronic nonbacterial cystitis in 75 cases of chronic cystitis. Among them, 38 （10.86%） cases were cystitis glandularis, 11 （3.14% ） cases were vesical leukoplakia and 9 （2.57%） cases were chronic hyperplastic cystitis. Six （10.34% ） cases were positive urine culture in 58 cases of accompanied chronic nonbacterial cystitis in upper urinary tract obstruction, and 27 （9.82% ） cases were positive urine culture in 275 cases without cystitis, as compared between the two groups（P〉0. 05）. Following up to 16 cases of accompanied chronic nonbacterial cystitis in upper urinary tract obstruction, the suspicious inflammation foci on the bladder in 10 cases was disappeared, but that in other 6 cases remained visible and needed further management. Conclusions： It is suggested that there would be an association of upper urinary tract obstruction with the accompanied chronic cystitis, and long--term upper urinary tract obstruction could induce chronic nonbacterial cystitis. The pathogenesis should be further studied.