三联药物膀胱灌注联合生物反馈治疗女性间质性膀胱炎/膀胱疼痛综合征的疗效分析
摘要
目的探讨三联药物膀胱灌注联合生物反馈治疗女性间质性膀胱炎/膀胱疼痛综合征(IC/PBS)的临床疗效。方法选取26例女性IC/PBS患者为研究对象,均行三联药物混合溶液(2%利多卡因20ml+肝素钠10万U+5%碳酸氢钠10ml+0.9%氯化钠溶液20ml)膀胱灌注,膀胱内保留1h后自行排出,1次/周,疗程2个月;同时联合生物反馈治疗,第1个月强化治疗(5次/周),第2个月间断治疗(3次/周),疗程2个月。比较治疗前与治疗1、2个月时O'Le a ry-Sa nt间质性膀胱炎症状评分(ICSI)、问题评分标准(ICPI)、盆腔疼痛及尿频评分(PUF)、焦虑自评量表评分(SAS)、24h日间及夜间排尿次数、平均每次排尿量、不良反应发生情况等。结果26例患者均完成全部治疗过程。治疗1、2个月时ICSI、ICPI、PUF、SAS、24h日间及夜间排尿次数、平均每次排尿量均较治疗前明显改善(均P<0.05)。治疗期间有1例患者首次膀胱灌注后出现轻度体温升高,未予特殊处理,后续灌注无明显不适;2例患者首次灌注后出现膀胱区疼痛加重,可耐受,继续接受第2次膀胱灌注后上述感觉逐渐消失。所有患者均未发生严重不良反应。结论三联药物膀胱灌注联合生物反馈治疗女性IC/PBS安全有效,易被患者接受。
引文
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[2]Dawson TE,Jamison J.Intravesical treatments for painful bladder syndrome/interstitial cystitis[J].Cochrane Database of Systematic Reviews,2007,7(4):CD006113.
[3]Tirumuru S,Alkurdi D,Latthe P.Intravesical botulinum toxin Ainjections in the treatment of painful bladder syndrome/interstitial cystitis:a systematic review[J].InternationalUrogynecology Journal,2010,21(10):1285.
[4]田钰,廖利民.间质性膀胱炎治疗的研究进展[J].中国康复理论与实践,2013,16(9):856-859.
[5]Gillenwater JY,Wein AJ.Summary of the national institute of arthritis,diabetes,digestive and kidney diseases workshop on interstitial cystitis,national institutes of health,bethesda,maryland,August 28-29,1987[J].Journal ofUrology,1988,140(1):203.
[6]Jp VDM,Nordling J,Bouchelouche P,et al.Diagnostic criteria,classification,and nomenclature for painful bladder syndrome/interstitial cystitis:an ESSIC proposal[J].European Urology,2008,53(1):60-67.
[7]Hanno P,Lin A,Nordling J,et al.Bladder pain syndrome committee of the international consultation on incontinence[J].Neurourology&Urodynamics,2010,29(1):191.
[8]Davis NF,Brady CM,Creagh T.Interstitial cystitis/painful bladder syndrome:epidemiology,pathophysiology and evidence-based treatment options[J].Eur J Obstet Gynecol Reprod Biol,2014,175(8):30-37.
[9]Hanno PM,Erickson D,Moldwin R,et al.Diagnosis and treatment of interstitial cystitis/bladder pain syndrome:AUA guideline amendment[J].Journal of Urology,2015,193(5):1545-1553.
[10]Toft BR,Nordling J.Recent developments of intravesical therapy of painful bladder syndrome/interstitial cystitis:a review[J].Current Opinion in Urology,2006,16(4):268.
[11]吕坚伟,薛蔚,冷静,等.碱化利多卡因联合肝素膀胱灌注治疗膀胱疼痛综合征/间质性膀胱炎215例报告[J].中华泌尿外科杂志,2008,29(1):54-56.
[12]Zhang W,Deng X,Liu C,et al.Intravesical treatment for interstitial cystitis/painful bladder syndrome:A network metaanalysis[J].Int Urogynecol J,2017,28(4):515-525.
[13]邓宏达,梁仁致,邓生智.肝素联合碱性利多卡因膀胱灌注治疗间质性膀胱炎疗效观察[J].中国全科医学,2010,13(18):2030-2031.
[14]Parsons CL,Zupkas P,Jeffrey Proctor MD,et al.Alkalinized lidocaine and heparin provide immediate relief of pain and urgency in patients with interstitial cystitis[J].Journal of Sexual Medicine,2012,9(1):207-212.