腺性膀胱炎临床诊疗分析(附47例报告)

Diagnosis and Treatment of Cystitis Glandularis(Report of 47 cases)

目的探讨不同程度及不同阶段腺性膀胱炎的治疗方法。方法回顾性分析47例腺性膀胱炎的临床资料,其中女38例,男9例,经尿道电切术+表柔比星膀胱灌注30例(手术+膀胱灌注组),单纯表柔比星膀胱灌注14例(膀胱灌注组),单纯对症治疗3例(病因治疗组)。结果随访8-30个月。手术+膀胱灌注组和膀胱灌注组尿频、尿急缓解率分别为83.5%和72.3%,血尿缓解率分别为87.6%和79.2%,排尿困难缓解率均为100%,下腹胀痛及尿痛不适缓解率分别为75.1%和63.3%,病因治疗组患者临床症状均完全消失。结论经尿道电切+化疗药物膀胱灌注治疗病变广泛且症状较重的腺性膀胱炎效果理想;病变及症状均较轻且无明显合并症的腺性膀胱炎可采用单纯膀胱灌注;病变轻微且有合并症的腺性膀胱炎可给予去除病因的对症治疗。腺性膀胱炎具有复发及恶变倾向,须密切随访。

Objective To investigate the optimal treatment of cystitis glandularis（ CG） of different severity. Methods The clinical data of 47cases（38 females and 9 males） of CG were reviewed. Thirty-three cases of CG were treated by transurethral resection combined with bladder irrigation of epirubicin （ surgery with medical group）. Fourteen cases were treated with bladder inigation of epirubicin conservatively（ medical group）. Three cases were treated by tran- surethral resection （ etiological treatment group）. Results All the patients were followed up from 8 to 30 months. The re- mission rate of frequency ,urgency in surgery with medical group and medical group was 83.5% and 72.3% ,respective- ly. The remission rate of hematuria was 87.6% and 79.2% ,respectively. The remission rate of difficulty of urination for both groups was 100%. The remission rate of abdominal distention was 75. 1% and 63.3% , respectively. The cases in the etiological treatment group were all Cured. Conclusions Transurethral resection and bladder irrigation of CG should be preferably performed for those cases whose lesions were severe and extensive. Bladder irrigation is equally effective for those with the superficial and limited lesions. Etiological treatment should be performed for those cases whose lesions were superficial,but combined with other diseases, such as BPH. Due to the recurrence and transform of malignancy, long-term follow- up is essential for those patients suffered from CG.