吸食K粉（氯胺酮）致泌尿系统损害误诊分析

Misdiagnosis analysis for street ketamine associated urinary system dysfunction

目的探讨吸食K粉（氯胺酮）相关的泌尿系统损害误诊原因。方法回顾性分析23例吸食K粉（氯胺酮）相关的泌尿系统损害患者K粉吸食资料及既往诊治情况。患者全为男性，年龄l8～52岁，K粉吸食史1～7年，有严重的排尿困难、尿频、尿急、尿痛、尿等待等下尿路症状，吸食K粉后反复发作或加重。结果23例患者被诊断为尿道炎、膀胱炎、慢性前列腺炎、非淋菌性泌尿生殖道炎、泌尿系结石，无1例诊断为吸食K粉（氯胺酮）相关的泌尿系统损害。结论患者有长期吸食K粉史，并因反复吸食而发作或加重；下尿路症状明显而严重；一般治疗效果不佳，停止吸食K粉后病情缓解。临床医师应注重病史。

Objective To explore the causes of the misdiagnosis for street ketamine associated urinary system dysfunction. Methods Restrospective study was performed on 23 patients suffering from street ketamine associated urinary system dysfunction. The clinical information of patients including their ketamine abuse datas and previous diagnosis and treatment were analyzed. The patients with age 18～52 years old ,all had abuse street ketamine for about 1～7 years, and they had severe lower urinary tract symptoms, complaint of severe frequency, urgency, dysuria, and urge incontinence. Once the patients abused street ketamine repeatedly, the symptoms whould recur and （or） aggravate over and overagain. Results The patients were misdiagnosed as urethritis, cystitis, chronic prostatitis, NGU,and Urinary calculus. But no one was diagnosed as street ketamine associated urinary system dysfunction. Conclusion The patients had abused street ketamine for a long time and; their symptoms will break out and （or） aggravate repeatedly if they abuse street ketamine again, andtheir lower urinary tract symptoms were more obvious and serious than that of other urinary diseases. It is poor effect for this disease using ordinary treatment, stopping ketamine abuse is an effective option for the disase.