膀胱热灌注联合膀胱灌注透明质酸钠液治疗腺性膀胱炎的临床疗效分析

Clinical analysis of bladder thermal instillation combined with intravesical instillation of sodium hyaluronate in treatment of cystitis glandularis

目的探讨经尿道等离子电切术后辅以膀胱热灌注联合膀胱灌注透明质酸钠液治疗腺性膀胱炎的疗效。方法选择2019年10月至2021年3月于河南省人民医院泌尿外科因腺性膀胱炎行经尿道等离子电切术的患者,共80例。术后将患者随机分为3组:A组:29例,患者术后行膀胱热灌注联合膀胱灌注透明质酸钠液治疗。B组:26例,患者术后行膀胱常温灌注透明质酸钠液治疗。C组:25例,患者仅行经尿道等离子电切术。所有患者均随访24周,定期复查膀胱镜,并于术后第4、12、24周填写临床症状评分表,对不良反应、复发率、临床症状进行分析。结果不良反应:A、B两组患者均无严重不良反应发生。复发率:24周后A组复发率低于B、C两组,且A、C两组差异有统计学意义(P<0.05);症状评分:3组患者术后第4周评分较术前均明显下降(P<0.05),其中A、B两组与C组相比差异存在统计学意义(P<0.05);术后12周及24周A、B两组症状评分均较前明显下降(P<0.05),且A、B两组组间差异有统计学意义(P<0.05),C组患者随访期间评分无显著变化(P>0.05)。结论膀胱热灌注联合膀胱灌注透明质酸钠液治疗腺性膀胱炎的临床疗效优于透明质酸钠液常温灌注及单纯等离子电切术,起效更快且安全性高,可有效预防CG的短期复发。

Objective To investigate the efficacy of bladder thermal instillation combined with intravesical instillation of sodium hyaluronate aftertransurethral plasma resection in the treatment of cystitis glandularis.Methods A total of 80 patients with cystitis glandularis were treated with transurethral plasma resection from October 2019 to March 2021 in the Department of Urology of Henan people’s Hospital.The patients were randomly divided into three groups:Group A:29 patients were treated with intravesical thermal perfusion combined with intravesical instillation of sodium hyaluronate after transurethral resection.Group B:26 patients were treated with room temperature infusion of sodium hyaluronate solution into the bladder after operation.Group C:25 patients were not treated with bladder instillation after electroresection.All patients were followed up for 24 weeks,and had a regular reexamination of cystoscope.The clinical symptom score form was completed at 4,12 and 24 weeks after perfusion,and then the recurrence rate and clinical symptoms were analyzed.Results Adverse reactions:there were no serious adverse reactions in group A and group B.After 24 weeks,the recurrence rate in group A was lower than that in group B and C,and there was significant difference between group A and group C(P<0.05).Symptom scores:after 4 weeks of perfusion treatment,the scores of the three groups were significantly lower than those before operation(P<0.05),and there was significant difference between group A,B and group C(P<0.05).The symptom scores of group A and B were significantly lower than those of the previous follow-up at 12 and 24 weeks after treatment(P<0.05).There was significant difference between group A and group B(P<0.05),but there was no significant change in the scores of group C during the follow-up period(P>0.05).Conclusion The clinical efficacy of bladder thermal instillation combined with intravesical instillation of sodium hyaluronate in the treatment of cystitis glandularis is better than that of normal temperature instillation of sodium hyaluronate and simple plasma resection,which take effect faster and safe,and can effectively prevent the short-term recurrence of CG.