上尿路梗阻伴发慢性非细菌性膀胱炎的诊治分析

【摘要】〓目的〓探讨上尿路梗阻伴发慢性非细菌性膀胱炎的诊治分析。方法〓回顾性分析137例上尿路梗阻住院病人伴发慢性非细菌性膀胱炎的临床资料,通过尿液培养、膀胱镜检查、活检等检查手段以及输尿管镜手术过程中确诊慢性非细菌性膀胱炎。结果〓137例中发现慢性非细菌性膀胱炎32例(23.4%),这其中上尿路因结石梗阻出现的慢性非细菌性膀胱炎27例(19.7%),非结石因素梗阻原因出现的慢性非细菌性膀胱炎5例(3.6%)。32例非细菌性膀胱炎,腺性23例,增生性3例,膀胱白斑病变6例,合并慢性输尿管炎、输尿管息肉11例。在32例上尿路梗阻伴发非细菌性膀胱炎病例中,中段尿细菌培养阳性3例,均为大肠埃希氏杆菌,96例不伴有慢性膀胱炎病例中中段尿培养阳性者11 例,大肠埃希氏杆菌10例,金葡菌和表皮葡萄球菌1例。6例上尿路梗阻伴发非细菌性膀胱炎病例予以随访3月,膀胱炎症病灶消失。结论〓上尿路梗阻情况下可伴发慢性非细菌性膀胱炎。

Analysis of diagnosis and treatment in the upper urinary tract obstruction associated with chronic nonbacterial cystitis

ObjectiveTo investigate nonbacterial cystitis in the upper urinary tract obstruction. Methods137 cases with upper urinary tract obstruction were included in the study. Chronic nonbacterial cystitis was confirmed by mid-stream urine culture（MSU）, cystoscopy, biopsy, and ureteroscopy. The incidence, diagnosis and treatment of nonbacterial of nonbacterial cystitis were investigated retrospectively. ResultsThirty-two cases of chronic nonbacterial cystitis were found in 137 cases with upper urinary tract obstruction（23.4%）, in which 27 cases were caused by upper urinary lithiasis obstruction（19.7%）, 5 cases by non-calculus obstruction（3.6%）. Of 32 cases,glandular cystitis had 23 cases, proliferative cystitis 3 cases, vesical leukoplakia lesion 6 cases. Moreover, the nonbacterial cystitis was complicated with chronic ureteritis and ureteral polyps in 11 cases. In the nonbacterial cystitis cases, MSU was positive in 3 cases （all caused by Escherichia coli）, while in 96 cases without nonbacterial cystitis, MSU was positive in 11 cases, including 10 cases of E.coli infection, one of staphylococcus aureus infection and one of staphylococcus epidermidis infection..Sixteen nonbacterial cystitis patients were followed up for 3 months post-treatment of relief of obtrucion..The patient got recovery. ConclusionThe upper urinary tract obstruction may be associated with high incidence of nonbacterial cystitis.