单纯粘膜电切治疗腺性膀胱炎(附51例报告).docVIP

单纯粘膜电切治疗腺性膀胱炎(附51例报告)【摘要】目的：探讨仅行粘膜电切而不进行膀胱内灌注化疗药物治疗腺性膀胱炎的可行性及效果。方法：将51例腺性膀胱炎患者分成两组，一组26例为对照组，行粘膜电切（或电灼）加膀胱内灌注化疗药物；一组25例为研究组，仅行膀胱粘膜电切治疗。观察两组术后3个月膀胱镜检查病变有无残留或新发以及症状改善情况，以比较两组的治疗效果。结果：两组比较差异无统计学意义（P0.05）。结论：单纯粘膜电切治疗腺性膀胱炎是可行的，可节省治疗费用，节约社会成本。 【关键词】腺性膀胱炎；电切术；膀胱灌注 Transurethral Electrocision as Only Modality for Cystitis Glandularis Qiang HUANG1Zhenhua FENG Department of Urology, the Municipal Hospital of Gaozhou, Gaozhou 525200,China 【Abstract】ObjectiveTo evaluate the efficacy and necessity of transurethral electrocision as only modality for cystitis glandularis. Methods A clinical data of 51 cases was reviewed.The cases were divided into two groups.One group of 26 cases as control was treated by transurethral electrocision or electric coagulation combined with bladder instillation of antitumor drugs.The other group of 25 cases as investigation was treated by transurethral electrocision as only modality.The cystoscopy was performed 3 months later after the operation to judge if the disease recurred and the efficacy of the two treatments was compared. Result There was no significance between the two groups（P0.05）. Conclusions Using transurethral electroresection as the main therapy without bladder instillation of antitumor drugs is feasible. This way could decrease patients cost and rconomize societys costs. 【Keywords】cystitis glandularis;electrocision;bladder instillation 腺性膀胱炎近年来发病率不断上升，治疗手段较为多样。2004年1月至2010年1月，我们将确诊腺性膀胱炎患者按治疗方案选择分为粘膜电切加膀胱内灌注化疗药物组及单纯膀胱粘膜电切治疗组。现将治疗效果及其随访情况报告如下。 1资料与方法 1.1临床资料本组51例，男15例，女36例，平均年龄49岁（30~72）岁。主要症状为膀胱刺激症状者31例，膀胱刺激症状伴肉眼血尿者6例，膀胱刺激症状伴排尿困难者6例，下腹不适或疼痛者8例。分组后两组临床资料基本相同。 1.2治疗方法根据治疗方法不同分成两组：对照组为粘膜电切+膀胱内灌注化疗药物；治疗组为单纯膀胱粘膜电切。经术前膀胱镜检病理检查确诊腺性膀胱炎后，对照组将病变粘膜用电切环电灼碳化或电切病变组织及其周围0.5CM，切除达浅肌层；术后每周灌注吡柔比星或丝裂霉素，连续6周。治疗组仅行粘膜电切，切除范围病变组织周围0.5CM，达浅肌层，术后不予膀胱内灌注药物化疗。 1.3随访情况通过膀胱镜检查观察两组术后3个月时病变有无残留复发，了解症状改善情况。标准：治愈（症状完全消失）；缓解（症状部分消失）；未愈（症状未得到明显改善）。 1.4统计学方法利用SPSS软件进行差异显著性检验，采用X2检验，以P0.05为差异有统计学意义。 2结果 26例对照组患者术后3个月复查膀胱镜，21例膀胱粘膜正常