膀胱水扩张联合肝素碱化利多卡因灌注治疗间质性膀胱炎

Treatment of interstitial cystitis with bladder hydrodistention and heparin with alkalinized lidocaine irrigation

目的：探讨膀胱水扩张加肝素碱化利多卡因灌注治疗间质性膀胱炎（IC）的临床有效性及安全性。方法：对20例IC患者采用麻醉下膀胱水扩张后，膀胱灌注肝素2．5万U＋5％碳酸氢钠5mL＋2％利多卡因10mL＋O．9％氯化钠溶液15mL的混合溶液，每周2次，4周后改每周1次，共16次。治疗前后进行Ic症状评分（ICSI）、问题评分（ICPI）及综合评价疗效。结果：20例患者随访6～24个月，平均lO个月。治疗后10例患者症状显著缓解，6例患者有效，4例患者无效，治疗有效率为80％。治疗前ICSI为10～17（14．80±1．94）分，ICPI为7～15（13．30土2．11）分。治疗4、12周后ICSI分别为（10．60±3．05）、（8．55±3．73）分、ICPI分别为（10．00土2．20）、（7．75±2，99）分。治疗前后比较差异有统计学意义（P〈0．05）。结论膀胱水扩张联合灌注肝素碱化利多卡因是治疗Ic的有效方法，可以明显缓解临床症状。

To evaluate the efficacy and security of bladder hydrodistention and heparin with alkalinized lidocaine to treat interstitial cystitis （IC）. Methods： Twenty patients with interstitial cystitis received bladder hydrodistention under anesthesia, then bladder irrigation with 2.5 x 105 U heparin＋5 mL of 5% sodium bicarbonate＋10 mL of 2% lidocaine＋15 mL of 0.9% NaCI injection. The treatment was given 2 times a week, after 4 weeks, the treatment was given 1 time a week, 16 times in all. The interstitial cystitis symptom index （ICSI） and interstitial cystitis problem index （ICPI） were evaluated respectively before the treatment and after the treatment. The treatment effect was evaluated comprehensively. Results： After 6-24 months＇ follow-up （an average of ten months） on 20 patients, 10 cases showed significant curative effect, 6 cases showed curative effect, while 4 cases showed no effect. The total effective rate was 80%. The ICSI score before treatment was from 10 to 17 （mean, 14.80 ± 1.94）, and the ICPI score was from 7 to 15 （13.30 ± 2.11）. The ICSI score was decreased to 10.60± 3.05 in 4 weeks, 8.55 ± 3.73 in 12 weeks; and the ICPI score was decreased to 10.00 ± 2.20 in 4 weeks, 7.75 ± 2.99 in 12 weeks after treatment, which was significantly distinct before and after the therapy （P〈0.05）. Conclusion： The treatment of interstitial cystitis with bladder hydrodistention and heparin with alkalinized lidocaine irrigation is effective, and can significantly relieve clinical symptoms and improve the life quality of patients with IC.