腺性膀胱炎的诊治(附96例报告)

Diagnosis and Treatment of Cystitis Glandularis:a Report of 96 Cases

目的:探讨腺性膀胱炎诊断和治疗的方法。方法:对96例腺性膀胱炎患者临床资料进行分析,其中反复尿路感染42例,无明显诱因的尿频尿急11例,血尿8例,下腹酸胀痛不适7例,排尿困难6例,膀胱肿瘤术后常规复查时发现者15例,置双"J"管后7例,其中合并膀胱结石8例,合并膀胱癌2例。65例经尿道汽化电切加膀胱内灌注化疗药物;15例仅行膀胱内灌注化疗药物;4例膀胱结石行膀胱部分切除加取石术;4例定期更换双"J"管;3例拔除双"J"管;3例伴有肾积水无法插入输尿管导管者行输尿管口移植术;2例伴发膀胱肿瘤患者行膀胱部分切除术。结果:72例(72/96,75.0%)获得随访,平均随访时间4.2年。手术切除病变、经尿道汽化电切加膀胱内灌注化疗药物、单纯膀胱内灌注化疗药物的治愈率分别为100%(6/6)、73.5%(36/49)和40.0%(4/10)。4例定期更换双"J"管者病变未见明显进展,3例拔除双"J"管复查膀胱镜见病变程度减轻。结论:腺性膀胱炎在确诊后应及时治疗,在治疗时应针对诱因或病因,手术切除、经尿道汽化电切加膀胱内灌注化疗药物是腺性膀胱炎的有效治疗方法。

Objective：To discuss the diagnosis and treatment of cystitis glandularis.Methods： The clinical data of 96 cases of cyctitis glandularis were analyzed retrospectively.Fifteen cases were found in the routine examination after the operation of bladder tumor,while 7 cases occurred after use double ＇J＇.6 cases complained of dysuresia.Recurrent urinary tract infection was found in 42 cases.Bladder stone were found in 8 cases and adenocarcinoma of bladder was found in 2 cases.Transurethral resection and instillation of bladder were performed in 65 cases.Partial resection of bladder and transplantation of ureteric orifice were performed in 3 cases because the ureteral catheter couldn′t be inserted in the ureter.Instillation of bladder was performed in 15 cases.Partial resection of bladder was performed in the case of adenocarcinoma of bladder.Results： 72 cases were followed up for 4.2 years.The cure rate of partial resection,transurethral resection combine instillation and instillation of bladder were 100%（6/6）,73.5%（36/49） and 40.0%（4/10）.The symptoms were stable in 4 cases with replace double ＇J＇ catheter regularity and relieved in 3 cases after removing the double ＇J＇ catheter.Conclusions： Cystitis glandularis should be treated actively because of its possibility of development to carcinoma.Etiological treatment is necessary in treatment.Transurethral recection is an effective method in treatment of cystitis glandularis.