碘伏膀胱灌注治疗间质性膀胱炎疗效观察

目的探讨0.5%碘伏膀胱灌注治疗间质性膀胱炎(IC)的疗效、安全性及副作用。方法33例IC患者随机分为A、B两组,A组采用0.5%碘伏50ml膀胱灌注,变换体位,保留2h后排空,1次/d,疗程14d;B组用1∶5000呋喃西林溶液替代碘伏,方法同A组。观察治疗前后A、B两组患者症状改善、膀胱镜检变化情况及副作用。结果33例患者随访8~22个月,平均18个月。A、B两组用药后,按O′Leary-Sant IC症状评分(ICSI)、问题评分(ICPI)比较差异均有高度统计学意义(P<0.01)。A组症状缓解15例,有效率83.3%;膀胱镜检所见黏膜下点状出血及Hunner溃疡消失显著12例,好转4例,有效率为88.9%。B组症状缓解7例,有效率为46.7%;膀胱镜检所见黏膜下点状出血及Hunner溃疡消失显著2例,好转3例,有效率33.3%。A组治疗有效率明显高于B组(P<0.01);其尿道灼痛、血尿、发热等副作用低于B组(P<0.05)。结论0.5%碘伏膀胱灌注可安全有效地治疗IC。

Interstitial cystitis: a analysis of treatment with intravesical povidone- iodine and follow - up patient survey

Objective To evaluate the efficacy,safety and side effects of 0.5% povidone-iodine in intravesical treatment of interstitial cystitis (IC). Methods Thirty-three cases of IC were divided randomly into group A (18 cases) and group B (15 cases). Group A was treated by intravesical instillation with 50 ml of 0.5% povidone-iodine which was kept in the bladder for 2 hours,once a day for 2 weeks. Group B was treated in the same way,but with 1:5000 furacilin instead. The symptoms,results of cystoscope inspect and adverse effects were investigated. Results All cases were followed up from 8 to 22 months (in average of 18 months). There was significant difference in the scores of clinical symptoms after treatment between two groups (P< 0.01 ). In group A,symptoms of 15 cases (83.3%) were relieved,and 16 cases (88.9%) of pathology observed by cystoscope inspect were improved. In group B,symptoms of 7 cases (46.7%) were relieved,and 5 cases (33.3%) of pathology observed by cystoscope inspect were improved. The efficiency of group A was significantly better than that of group B (P< 0.01) . The side effects such as causalgic urethra,hematuria,fever and so on in group A were significantly lower than that of group B (P< 0.05) . Conclusions Intravesical instillation with 0.5% povidone-iodine is a safe and effective method for treatment of IC.