上尿路梗阻与伴发慢性膀胱炎的关系

Association of upper urinary tract obstruction and concurrent chronic cystitis

目的探讨上尿路梗阻与伴发的慢性膀胱炎的关系。方法选取138例上尿路梗阻患者,通过对其进行尿液细菌培养、膀胱镜及输尿管镜检查,确定伴发慢性膀胱炎情况。结果 138例中,结石性梗阻105例,非结石性梗阻33例。确诊膀胱黏膜炎症性改变者37例,慢性膀胱炎发病率为26.81%。结石性梗阻患者慢性膀胱炎发病率28.57%(30/105),与非结石梗阻患者的21.21%(7/33)相仿(P>0.05)。结石性梗阻和非结石性梗阻伴有慢性膀胱炎的患者均以非细菌性膀胱炎为主,发生率分别为70.00%和71.43%(P>0.05)。无膀胱炎和非细菌性膀胱炎患者尿液细菌培养阳性率明显低于细菌性膀胱炎患者(9.90%和9.09%vs.92.59%)(P<0.01)。结论上尿路梗阻患者容易伴发非细菌性慢性膀胱炎,长期的尿路梗阻可能是其主要诱发原因。

Objective To investigate the relationship between upper urinary tract obstruction and concurrent chronic cystitis. Methods Data of 138 patients with urinary tract obstruction were retrospectively analyzed, who were examined by urine bacterial culture, cystoscopy and ureteroscopy. Results Of 138 patients, calculus obstruction was disgnosed in 105 cases and nonealculus obstruction in 33 cases. Thirty-seven cases had concurrent chronic cystitis with the incidence rate of 26.81%. The incidence rate of chronic cystitis in the patients with calculus upper urinary tract obstruction was similar to that in those with noncalculus obstruction（28.57 % vs. 21.21 %）（P〉0.05）. The incidence rate of nonbacterial cystitis in the patients with calculus upper urinary tract obstruction was similar to that in those with noncalculus obstruction （70.00% vs. 71.43%）（P〉0. 05）. The positive rates of urine bacterial culture in the patients of upper urinary tract obstruction without cystitis and with nonbacterial cystitis were 9.90% and 9.09%, respectively, which were significantly lower than 92.59% in those with bacterial cystitis（P〈0. 01）. Conclusion The patients with upper urinary tract obstruction are easy to have concurrent nonbacterial chronic cystitis. Long-term urinary tract obstruction may be the main factor for inducing chronic cystitis.