经尿道电气化术治疗腺性膀胱炎25例临床分析

目的探讨腺性膀胱炎的诊断和治疗方法。方法经膀胱镜结合组织活检确诊的25例腺性膀胱炎患者,均行经尿道电气化术治疗。结果25例均获得12个月随访,22例治愈,3例好转,无1例癌变。结论经尿道电气化术是治疗腺性膀胱炎的主要治疗方法。     

Case Report: Cystitis Glandularis Mimics Bladder Tumour: A Case Report and Diagnostic Characteristics

We report a rare case of a 26-year-old patient presented with 3-week history of frank haematuria and suprapubic discomfort. Investigations revealed a tumour arising from the bladder wall and histology demonstrated cystitis glandularis. The literature review highlights the rarity of cystitis glandularis presented in such manner. Our radiographic and endoscopic images can also assist future diagnosis of the condition especially in patients in such age groups.     

腺性膀胱炎中肿瘤相关指标的改变和临床分型的探讨

目的探讨腺性膀胱炎的良恶性及癌变可能性,并探讨临床分型的合理性。方法根据膀胱镜下表现将腺性膀胱炎分为低危型及高危型。25例腺性膀胱炎新鲜组织,其中低危型12例,高危型13例,用流式细胞术检测其DNA含量;38例腺性膀胱炎蜡块组织,其中低危型20例,高危型18例,用免疫组织化学的方法研究增殖细胞核抗原(PCNA)、突变型p53、p21ras、bcl2及Rb等的表达。结果正常二倍体DNA指数为1.00±0.03,低危型腺性膀胱炎组为1.01±0.05,高危型组为1.05±0.07,低危型组和高危型组之间的差异无统计学意义(t=1.639,P=0.115);PCNA及p53在低危型组均表达阴性,在高危型组分别表达5例(27.8%)及4例(22.2%),两组之间的差异有统计学意义(P值分别为0.017、0.041);p21ras、bcl2及Rb在低危型组和高危型组的表达差异无统计学意义。结论高危型腺性膀胱炎和低危型腺性膀胱炎同为良性病变。高危型有发生恶变的可能性,因此将腺性膀胱炎分为高危型及低危型具有合理性。p53基因可能在高危型腺性膀胱炎的恶变过程中有重要作用。     

间质性膀胱炎的诊断和治疗探讨

目的探讨间质性膀胱炎的诊断与治疗。方法回顾性分析2002年7月—2004年6月诊治的10例间质性膀胱炎患者的临床资料。患者均为女性。平均年龄41岁;平均病程3.4年。符合美国国立糖尿病、消化和肾脏疾病学会间质性膀胱炎诊断标准。均行钾离子敏感试验,8例呈阳性反应。O′Leary Sant间质性膀胱炎症状评分9～20分,平均(14±4)分。所有病人首先行治疗性水扩张,1个月后评价疗效,对疗效不佳和水扩张后复发者行其他治疗。结果10例平均随访7.8个月。水扩张后1个月症状评分降至4～19分,平均(11±6)分,治疗前后比较,差异有统计学意义(t=4.394,P<0.05)。症状显著缓解2例,评分下降>7分;部分缓解3例,评分下降>3分。无效5例。有效率50%。结论钾离子敏感试验在间质性膀胱炎患者中有较高的阳性率。治疗性水扩张可作为首选的治疗方法。     

Contribution of antioxidants to preventive effect of mesna in cyclophosphamide-induced hemorrhagic cystitis in rats

Purpose The aim of this study was to evaluate whether combination of antioxidants and mesna may prevent cystitis induced by cyclophosphamide better than mesna alone.Materials and methods A total of 46 male Spraque-Dawley rats were divided into six groups. Five groups received single dose of cyclophosphamide (CP, 100 mg/kg) intraperitoneally with the same time intervals: group 2 received CP only, group 3 received mesna (21.5 mg/kg for three times), group 4 beta-carotene (20 mg/kg for two times) and mesna, group 5 received alpha-tocopherol (20 mg/kg for two times) and mesna, and group 6 received melatonin (5 mg/kg for two times) and mesna on the day of CP injection. Group 1 served as control.Results CP injection resulted in severe cystitis. Mesna has showed meaningful but not full protection against CP toxicity. Although beta-carotene did not show any additional beneficial effect when combined with mesna, alpha-tocopherol and especially melatonin with mesna resulted full protection that the pathologist, blinded to the slides, could not differ from sham control.Conclusion Oxidants may be important in the pathogenesis of CP-induced cystitis. Melatonin and alpha-tocopherol may help to ameliorate bladder damage along with other drugs such as mesna and diuretics.     

Prevention of recurrent bacterial urinary tract infections by intravesical instillation of hyaluronic acid.

OBJECTIVE: To evaluate the efficacy of vesical instillation of hyaluronic acid against recurrent urinary tract infections. METHODS: Twenty women with a history of recurrent urinary tract infections each received 9 intravesical instillations of hyaluronic acid over 6 months. Their status was assessed prospectively over 47.6 weeks and compared with a retrospective review of patient charts covering 36.2+/-6.2 weeks. RESULTS: The total numbers of urinary tract infections were 67 before and 10 after treatment (p<0.001). Thirteen patients (65%) were free of recurrences until the end of the study. One had a recurrence during treatment, and 6 (30%) during follow-up. The number of infections per year per patient was reduced from 4.99+/-0.92 to 0.56+/-0.82 (p<0.001). In women with recurrences, time to recurrence was 178.3+/-25.5 days, compared with 76.7+/-24.6 days before treatment (p<0.001). CONCLUSION: Intravesical instillation of hyaluronic acid is effective in preventing recurrent urinary tract infections.     

经尿道电切术联合术后表柔比星膀胱灌注治疗腺性膀胱炎(附130例报告)

目的探讨经尿道电切术联合术后表柔比星膀胱灌注治疗腺性膀胱炎的疗效。方法2000年1月～2006年1月,对130例腺性膀胱炎采用经尿道电切术,电切时切除所有病变黏膜及周边1cm正常膀胱黏膜,切除深度直达浅肌层。术后1周开始表柔比星膀胱灌注,每次50mg,每周1次,共8次,以后每月1次,持续2年。结果5例术后尿道狭窄,经定期扩张后治愈,余无并发症。98例症状消失,23例偶有尿路刺激症状,复查膀胱镜黏膜正常;9例复发,其中5例术后6～12个月出现非灌注后血尿,4例无症状定期复查,行膀胱镜检查见原位复发,活检病理确认后再次行经尿道电切术,术后更换灌注药物为羟基喜树碱,每次20mg,随访12个月,无复发。结论经尿道电切术联合术后有效化疗药物膀胱灌注治疗腺性膀胱炎,疗效满意,值得推广应用。     

经尿道双极等离子电切加膀胱药物灌注治疗腺性膀胱炎47例报告

目的:探讨经尿道双极等离子电切加膀胱药物灌注治疗腺性膀胱炎的疗效。方法:对47例腺性膀胱炎患者行经尿道双极等离子电切术及术后膀胱内丝裂霉素灌注治疗。结果:47例随访6个月,治愈40例,好转4例,3例于术后5个月复发。结论:经尿道双极等离子电切加膀胱药物灌注是治疗腺性膀胱炎的较好方法,既可消除临床症状,又可预防复发和恶变。     

吡柔比星(THP)膀胱灌注预防腺性膀胱炎术后复发的疗效观察

目的 评价吡柔比星(THP)膀胱灌注预防腺性膀胱炎术后复发的疗效。方法 对30例腺性膀胱炎患者行经尿道汽化电切术,术后定期应用THP(40mg/50ml)膀胱内灌注化疗。结果 30例患者随访5～20个月,平均14.5个月,3例复发(10％)。未见有全身性药物不良反应,仅2例血白细胞降至3000个/ml。结论THP膀胱灌注预防腺性膀胱炎术后复发疗效满意,病人耐受性好,副作用小。     

间质性膀胱炎患者尿液中特异性上皮生长因子的变化

目的　探讨间质性膀胱炎 (IC)患者尿液中生长因子水平变化的意义。　方法　应用ELISA法测定 35例IC患者和 2 0例无症状正常对照者尿液中上皮生长因子 (EGF)、胰岛素样生长因子 (IGF1)、胰岛素样生长因子结合蛋白 3(IGFBP3)及肝素结合的上皮生长因子 (HB EGF)的水平。　结果　IC组和对照组患者尿液中HB EGF浓度分别为 (2 .17± 0 .2 1)ng/ml和 (6 .5 9± 0 .97)ng/ml,两组间差别有显著性意义 ,P <0 .0 1。两组患者尿液中EGF、IGF1和IGFBP3浓度分别为 (15 .5 9± 1.74)ng/ml和 (7.5 8± 0 .97)ng/ml,(2 2 .46± 2 .0 4) pg/ml和 (12 .98± 1.17)pg/ml,(14.5 6± 2 .37)ng/ml和 (6 .16± 0 .82 )ng/ml,IC患者EGF、IGF1和IGFBP3水平均明显升高 ,差别有显著性意义 ,P <0 .0 1。　结论　尿液中上皮细胞生长因子的变化与间质性膀胱炎有关 ,HB EGF可作为诊断IC的标记物之一。