摘要
目的评估膀胱内灌注透明质酸治疗顽固性非细菌性膀胱炎,缓解其尿路刺激症状的疗效及安全性。方法对20例顽固性非细菌性膀胱炎患者行膀胱内灌注透明质酸溶液治疗。男1例,女19例。年龄22～68岁,平均47岁。病程1个月～30年,其中＞1年者16例。治疗方法为1周1次×4次,然后4周1次×2次,随访至第16周。根据患者主观感受填写视觉模拟量表进行疗效评估并记录不良事件。治疗结果分为完全反应(症状消失或症状总分减少≥90%)、部分反应(症状总分减少50%～89%)、轻度反应(症状总分减少≤49%)和无反应(症状评分无改善)。结果除1例患者中途退出外,共19例患者完成了16周的随访,症状总分从平均22.32±5.53下降至9.47±5.88(P＜0.001),尿频评分从8.21±1.75下降至3.89±2.31(P＜0.001),尿急评分从7.47±2.14下降至3.37±2.14(P＜0.001),尿痛评分从6.63±3.47下降至2.21±2.74(P＜0.001)。第16周时总有效率(完全反应及部分反应)为53%(10/19)。除操作本身引起的不良反应如尿道刺激(25%,5/20)、膀胱胀痛加重(5%,1/20)和改变体位时引起的头晕(15%,3/20)外,未发现其他不良反应。结论膀胱内灌注透明质酸对顽固性非细菌性膀胱炎患者的尿路刺激症状有明显的改善作用,安全,依从性好。
Objective To evaluate the efficacy and safety of intravesical instillation of sodium hyaluronate in relieving the symptoms of refractory non-bacterial cystitis. Methods Totally,20 patients （ 1 man and 19 women;mean age,47 years ;age range,22 -68 years） with refractory non-bacterial cystitis were included. Their disease course ranged from 1 month to 30 years. Of them, 16 patients had the disease for more than 1 year. Instillation of sodium hyaluronate （50 ml solution of 40 mg HA） was performed intravesically in them for a total of 12 weeks （once a week for the first 4 weeks and once every 4 weeks for the succeeding 8 weeks）. Follow-up visit ended at 16 weeks,when the patients filled in the symptom assessment scores （VAS on pain, frequency and urgency） according to the subjective evaluation. Therapeutic results were classified as （ 1 ） total response： symptom disappearance or relief by at least 90% of the symptom scores ; （2） partial response： symptom relief by 50% - 89% ; （3） mild response： symptom relief by 49% or less; （4） no response： no improvement in symptom scores. Results Nineteen patients completed the 16-week follow-up with only 1 withdrawing. The average general symptom score decreased from 22.32 ± 5.53 to 9.47 ± 5.88 （ P 〈 0. 001 ） ;frequency score from 8.21 ± 1.75 to 3.89 ± 2.31 （ P 〈 0. 001 ） ; urgency score from 7.47 ±2.14 to 3.37 ±2.14 （P 〈0. 001） ; pain score from 6.63 ± 3.47 to 2.21 ± 2.74 （P 〈 0. 001）. After 16 weeks, overall positive response rate （total ＋ partial response） was 53% （10/19）. No serious adverse effect occurred except for urethral irritation （25 % ,5/20） ,worsening of distending pain of the bladder （5 % , 1/20） and vertigo （ 15% ,3/20） caused by the procedure itself. Conclusions For patients suffering from refractory non-bacterial cystitis,intravesical instillations of sodium hyaluronate can significantly relieve the symptoms and is safe and of good patient compliance.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2006年第7期483-485,共3页
Chinese Journal of Urology
关键词
透明质酸
膀胱炎
投药
膀胱内
Hyaluronic acid
Cystitis
Administration,intravesical
