连续膀胱内灌注透明质酸钠联合高压氧仓治疗放射性膀胱炎出血的疗效观察

目的 探讨连续膀胱内灌注透明质酸钠联合高压氧仓治疗放射性膀胱炎出血的疗效。方法 选取2015年1月—2019年1月在温州市中西医结合医院因盆腔恶性肿瘤接受放射治疗发生放射性膀胱炎出血的患者40例。按照随机分配的原则将患者分为联合治疗组（连续膀胱内灌注透明质酸钠联合高压氧仓）和高压氧组，每组20例。治疗前和治疗后6个月、12个月、18个月评估患者血尿症状、排尿频率及血尿色卡评分（1～10分）。结果 两组治疗后6个月、12个月和18个月的完全缓解率和部分缓解率比较，差异无统计学意义（P >0.05）。两组治疗前和治疗后6个月、12个月、18个月的排尿频率和血尿色卡评分在不同时间点、不同组间有差异（P <0.05），联合治疗组的排尿频率和血尿色卡评分较低，相对效果较好。两组排尿频率变化趋势无差异（P >0.05），但血尿色卡评分变化趋势有差异（P <0.05）。治疗6个月时，联合治疗组副作用发生率高于高压氧仓治疗（P <0.05），但治疗12个月和18个月时两组副作用发生率比较，差异无统计学意义（P >0.05）。结论 连续膀胱内灌注透明质酸钠联合高压氧仓治疗放射性膀胱炎出血患者具有良好的耐受性，可使膀胱出血、血尿严重程度和排尿频率持续降低至少12个月。

Effect of continuous intravesical installation of sodium hyaluronate combined with hyperbaric oxygen therapy on radiation-induced hemorrhagic cystitis

Objective To investigate the effect of continuous intravesical installation of sodium hyaluronate combined with hyperbaric oxygen therapy on radiation-induced hemorrhagic cystitis.Methods A total of 40 patients suffering from hemorrhagic cystitis after receiving radiotherapy for pelvic malignant tumors and visiting our hospital from January 2015 to January 2019 were randomly divided into combination group treated with continuous intravesical installation of sodium hyaluronate combined with hyperbaric oxygen therapy and hyperbaric oxygen group treated with hyperbaric oxygen therapy alone. The hematuria, urination frequency, and the score of hematuria colorimetric card (1 to 10) were evaluated 6 months prior to the treatment, and 6, 12 and 18 months after the treatment.Results There was no significant difference in the complete remission rate and partial remission rate between the two groups at 6, 12 and 18 months after the treatment (P > 0.05). The urination frequency and the score of hematuria colorimetric card were different between the two groups and among different time points after the treatment (P < 0.05). The urination frequency and the score of hematuria colorimetric card were lower in the combination group, which was suggestive of a better effect of the combined treatment (P < 0.05). There was no difference in the change trend of urination frequency between the two groups (P > 0.05), but the change trend of the score of hematuria colorimetric card was different between the two groups (P < 0.05). At 6 months after the treatment, the incidence of side effects in the combination group was higher than that of the hyperbaric oxygen group (P < 0.05). However, there was no significant difference in the incidence of side effects between the two groups at 12 and 18 months after the treatment (P > 0.05).Conclusions The continuous intravesical installation of sodium hyaluronate combined with hyperbaric oxygen therapy is well tolerated for the treatment of radiation-induced hemorrhagic cystitis. It can continuously reduce bladder bleeding, severity of hematuria and urination frequency for at least 12 months.