A型肉毒毒素膀胱三角区黏膜下注射治疗氯胺酮相关性膀胱炎的临床观察

目的探讨A型肉毒毒素(BTX-A)联合碱化利多卡因膀胱灌注+水压扩张治疗氯胺酮相关性膀胱炎的疗效。方法将33例氯胺酮相关性膀胱炎患者按治疗方式分为2组:A组15例,采用碱化利多卡因膀胱灌注+水压扩张;B组18例,在同A组治疗的基础上,加用膀胱三角区黏膜下注射BTX-A治疗。评估患者治疗前及治疗后1周、1个月、3个月的临床症状改善情况(每日排尿次数、最大排尿量、OLeary-Sant间质性膀胱炎症状评分ICSI及ICPI评分作为疗效评判标准),并记录不良反应的发生情况。结果 B组在治疗后1周、1个月、3个月症状较A组明显改善;各时间点每日排尿次数、最大排尿量、ICSI评分及CIPI评分与A组相比均有显著差异(P0.05)。两组均未出现严重不良反应。结论 BTX-A联合碱化利多卡因水压扩张治疗氯胺酮相关性膀胱炎,是一种安全有效的治疗方法,且无严重并发症。

Clinical observation of treatment for Ketamine associated cystitis with suburothelial injection of botulinum A toxin

Objective To explore the clinical effects of suburothelial injection of botulinum a toxin （BTX-A） combined with bladder installation of alkaline lidocaine and hydraulic expansion in the treatment of Ketamine associated cystitis. Meth- ods A total of 33 cases of Ketamine associated cystitis were divided into two groups： group A （ n = 15） and group B （ n = 18）. Group A received bladder installation of alkaline lidocaine and hydraulic expansion, group B underwent the same treatment with group A, plus suburothelial injection of BTX-A. The changes of symptoms 1 week, 1 month and 3 months after treatment were evaluated, including daily emiction frequency, maximum bladder capacity and O＇ Leary-Sant interstitial cystitis symptom score of ICS[ and ICPI, and all adverse reactions were recorded. Results There were significant differences in daily emiction frequency, maximum bladder capacity and O＇ Leary-Sant interstitial cystitis symptom score of ICSI and ICPI between group A and B. No patients had serious adverse reaction. Gonclusion BTX-A combined with alkalinized lidocaine hydrostatic is a safe and effective treatment for Ketamine associated cystitis and serious complications.