尿路上皮癌膀胱药物灌注致重度膀胱功能损害的碱化利多卡因灌注治疗

Distensible intravesical instillation of alkalinizedlidocaine in the treatment of drug-induced severe bladder dysfunction after post-operative of urothelial carcinoma with intravesical instillation

目的:评价碱化利多卡因扩张性灌注治疗尿路上皮癌膀胱灌注后药物相关性重度膀胱损害的疗效与安全性。方法:对6例尿路上皮癌患者因行吡柔比星、丝裂霉素及BCG灌注引起的重度膀胱损害,其中3例为灌注BCG行三联抗结核药物等综合治疗无效而被迫放弃、中止治疗者,采用膀胱镜检后碱化利多卡因扩张性灌注方法进行治疗,并评估治疗前、后下尿路症状及其相关指标。结果:6例患者下尿路症状及评分、膀胱容量流率、膀胱敏感性明显改善,并完全恢复原来的化学药物灌注。平均随访10(3～16)个月,无膀胱损害症状复发,效果满意。结论:应用碱化利多卡因扩张性灌注治疗尿路上皮癌膀胱灌注后药物相关性重度膀胱损害,是有效和安全的,可恢复尿路上皮癌患者行膀胱灌注药物的耐受依从性。

Objective：To evaluate the safety and efficacy of distensible intravesical instillation of alkalinizedlidocaine in the treatment of drug-induced severe bladder dysfunction of urothelial carcinoma with intravesical instillation,and improve compliance of them. Method：Six cases of severe bladder dysfunction with intravesical instillation of THP, MMC, BCG who experienced of long-term antibiotics and M-receptor blockage isineffective and was forced to give up. All patients were treated with distensible intravesical instillation of alkalinizedlidocaine, assessed before treatment and after treatment of lower urinary tract symptom score, voiding diary, urodynamic examination （bladder capacity ,urinary flow rate, residual urine,bladder sensitivity）. Result： Lower urinary tract symptoms, bladder capacity,sensitivity in the six cases of drug-induced severe bladder injury patients were significantly improved. With the follow-up of 10（3-- 16） months, the effect is satisfied. Conclusion： Distensible intravesical instillation of alkalinizedlidocaine in the treatment of drug-induced severe bladder dysfunction after post-operative of urotbelial carcinoma with intravesical instillation is an effective,safe and feasible procedure.