肉毒素联合膀胱灌注治疗间质性膀胱炎

Efficacy and Safety Analysis of Botulinum Toxin Injection Combined with Intravesical Instillation of Heparin in Treatment of Interstitial Cystitis

目的:评价肉毒素注射联合肝素、利多卡因、碳酸氢钠膀胱灌注治疗间质性膀胱炎的疗效。方法:将20例间质性膀胱炎患者随机分为两组,联合组在麻醉下行膀胱内200U肉毒素多点注射,3d后行2%利多卡因8mL、肝素37500万U、5%碳酸氢钠5mL膀胱灌注,每周1次,治疗周期1个月;透明质酸钠组膀胱灌注每周1次,治疗周期1个月,并对疗效进行随访。结果:随访1年,透明质酸钠组症状评分、问题评分、日排尿次数、最大膀胱容量指标较治疗前未发现明显改善(P>0.05);联合组以上指标较治疗前均有明显改善(P<0.05)。结论:肉毒素联合肝素、利多卡因、碳酸氢钠膀胱灌注治疗间质性膀胱炎,疗效明显优于透明质酸钠,该治疗方案值得进一步临床推广应用。

Objective To evaluate the clinical effects of botulinum toxin injection(BTI)combined with heparin+sodium bicarbonate+lidocaine bladder perfusion for the treatment of interstitial cystitis.Methods Twenty patients with interstitial cystitis were randomly divided into two groups.BTI+heparin+lidocaine+sodium bicarbonate and intravesical sodium hyaluronate were used for the therapy,respectively.BTI(200 U)was injected,and 2%lidocaine(8 mL)+heparin(37 500 million U)+5%sodium bicarbonate(5 mL)were used for bladder perfusion after 3 d.This therapy was repeated once a week and last for a month.In sodium hyaluronate group,intravesical instillation of sodium hyaluronate was used once a week and lasted for one month.Results Then all patients were followed up.The symptom score,problem score,daily urination frequency and maximum bladder volume in sodium hyaluronate group were not significantly improved compared with those before treatment(P>0.05);the above indicators in the combined group were significantly improved compared with those before treatment(P<0.05).Conclusion BTI combined with heparin+sodium bicarbonate+lidocaine+intravesical therapy treat for interstitial cystitis was more effective than sodium hyaluronate.