氯胺酮相关性膀胱炎的尿动力检查及分析

目的：分析氯胺酮相关性膀胱炎患者膀胱功能下降后的尿动力学表现，为临床治疗方法的选择及治疗后疗效评价提供依据。方法：通过对临床及检验证实的14例氯胺酮相关性膀胱炎患者行尿动力学检查，分析其表现特点。结果：①膀胱过度敏感：其中膀胱初始尿意、正常尿意及最大膀胱容量均明显低于正常；②逼尿肌过度活动：14例患者均表现为在充盈期出现不可抑制性收缩并产生排尿反射；③膀胱顺应性：14例患者中3例表现为下降，11例在产生排尿反射前未出现逼尿肌压力上升；④逼尿肌收缩功能：8例患者最大尿流率时逼尿肌压力减弱，4例正常，2例逼尿肌收缩增强；⑤膀胱出口梗阻表现不明显。结论：氯胺酮相关性膀胱炎患者的尿动力学主要表现为储尿期膀胱感觉过敏、小容量膀胱、不稳定或伴低顺应性膀胱，排尿期逼尿肌收缩减弱。

Urodynamic examination and analysis in ketamine cystitis

Objective： To analyze the urodynamic manifestation of ketamine cystitis associated with bladder function impairment in order to provide the elementary data for the guidelines of the treatment. Method： The clini-cal data of 14 cases of ketamine cystitis were collected. The urodynamic characteristics were analyzed retrospec-tively. Result： ①The bladder became hypersensitive. The first sensation, the first urge and the maximum toler-ance capacity of the bladder were significantly lower than normal. ②The detrusor showed overactive. The detru-sor of all the 14 patients had involuntary contraction and lead to micturition reflex during the filling period. ③The changes of bladder compliance were evaluated. Three cases showed declined in bladder compliance. Not until the micturition reflex appeared did the detrusor pressure increase in 11 cases. ④The detrusor pressure in eight cases were weakened, four cases were normal, two cases were strenghened when maximum urinary flow rate was detec-ted. ⑤ladder outlet obstruction was not obvious. Conclusion： The urodynamic characteristics of ketamine cystitis may mainly include bladder hyperesthesia, small capacity, instabte or low compliance bladder during the filling pe-riod and weak detrusor contraction during micturition phase.