氯胺酮相关性泌尿系统损害56例分析

Analysis on 56 Cases of Ketamine-associated Urinary System Dysfunction

目的:探讨滥用氯胺酮所引起的泌尿系统损害及诊治方法。方法:回顾性分析56例有滥用氯胺酮史患者的泌尿系统症状、体征、泌尿系统相关检查,根据不同情况予以相关治疗方案的探讨。结果:氯胺酮相关性泌尿系统损害主要症状为下尿路症状(LUTS),膀胱病理活检表现为不同程度的炎症改变。影像学检查可见不同程度的病变,主要表现为:膀胱容量小,膀胱壁增厚,膀胱挛缩,输尿管狭窄,肾积水。3例患者血清肌酐升高。结论:氯胺酮相关性泌尿系统损害是以下尿路症状(LUTS)为主要临床表现的疾病,疾病早期为可逆性,治疗效果良好,后期继发的膀胱挛缩和肾功能损害是不可逆的,需要引起重视。

To explore the diagnosis and treatment of ketamine-associated urinary system dysfunction. Methods. Totally 56 cases of urinary tract symptoms with the history of ketamine abuse in recent years were retrospectively analyzed. The routine examination and the examination related to the urinary system were given, and individual treatment was undertaken according to different situation. Results： The main symptom of ketamineasscociated urinary tract dysfunction was lower urinary tract symptom （LUTS）. Bladder pathologic biopsy showed different degree of inflammatory change. Imaging examination showed various degree of pathological changes, including reduced bladder capacity, thickened bladder wall, bladder contracture, ureteral stricture and hydronephrosis. Three patients had increased serum creatinine level. Conclusion： Ketamine-asscociated urinary system dysfunction is a disease with LUTS as the main clinical symptom. At the early stage, the disease is reversible with promising treatment outcome. In the progression of the disease, some patients develop irreversible histological changes in the urinary tract, which should be brought to the forefront.