女性腺性膀胱炎合并膀胱颈梗阻的微创诊疗

Minimally invasive diagnosis and therapy of female glandular cystitis combined with bladder neck obstruction

目的评价女性腺性膀胱炎合并膀胱颈梗阻的微创诊疗效果。方法对经膀胱镜检查确诊的48例女性腺性膀胱炎合并膀胱颈梗阻患者行经尿道电切术,对其中11例合并尿道口处女膜伞畸形或处女膜融合者作成形术,对7例膀胱内广泛腺性病变患者术后以吡柔比星灌注。所有病例术后采取短期抗炎和α受体阻滞剂口服治疗,25例绝经患者补充小剂量雌激素治疗。治疗前和治疗后12周各作视觉模拟评分(VAS)评分一次。结果 48例患者均得到3个月以上随访,其中29例(60.4%)疗效显著,12例(25.0%)中等,7例(14.6%)疗效差或无效,对其中6例再做膀胱镜检查提示腺性膀胱炎复发,但复发的范围和密度较术前减少。结论对女性腺性膀胱炎合并膀胱颈梗阻患者,膀胱镜检查可提示诊断及诊断术后复发,经尿道电切病变腺体及膀胱颈部电切解除梗阻疗效满意。

Objective To elevate effect of minimally invasive diagnosis and therapy of female glandular cystitis combined with bladder neck obstruction. Methods 48 female cases of diagnosed cystitis glandularis with bladder neck obstruction by cystoseopy were performed with transurethral electrical resection. Among them, 11 cases complicated with urethral orifice and hymenal fimbria deformation were performed with additional shaping operation, and 7 complicated with widespread adrenal disease inside bladder were instilled with pirarubicin. All patients received treatment of short time anti-inflammation and oral α-blocker, and menopause patients received complementary small dose of estrin. Visual Analogue Scale （VAS） was observed before and after a 12-weeks treatment. Results During the 12-weeks of follow-up,29 patients （60.4%） were cured,12 patients（25.0% ） improved,and 7 patients（ 14.6% ） unimproved,the effective rate was 85.4%. 6 patients were indicated recurrent glandular cystitis by cystoscopy, but with less scope and density. Conclusions Cystitis glandularis with the neck obstruction of urinary bladder in female can be diagnosed by cystoscope. Transurethral resection is efective for treating it.