上海交通大学学报（医学版）

上海交通大学学报（医学版）

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透明质酸钠与肝素钠联合利多卡因治疗间质性膀胱炎的临床比较观察

陆国樑，王大伟，邵远，徐达   

  1. 上海交通大学 医学院附属瑞金医院北院, 上海 201800
  • 出版日期:2015-11-28 发布日期:2016-01-13
  • 通讯作者: 邵远, 电子信箱: shaoyuan15@hotmail.com。
  • 作者简介:陆国樑（1985—）， 男， 主治医师， 硕士; 电子信箱: lgl1111@gmail.com。
  • 基金资助:

    2015年瑞金医院北院研究基金（2015ZY09）

Comparative study on intravesical hyaluronic acid instillation and heparin-lidocaine instillation for the treatment of interstitial cystitis

LU Guo-liang, WANG Da-wei, SHAO Yuan, XU Da   

  1. Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine， Shanghai 201800
  • Online:2015-11-28 Published:2016-01-13
  • Supported by:

    Research Foundation of Ruijin Hospital North in 2015， 2015ZY09

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摘要：

目的  探讨透明质酸钠与肝素钠联合利多卡因分别膀胱灌注治疗间质性膀胱炎的疗效及预后。方法  回顾从2013年2月至2015年4月上海交通大学医学院附属瑞金医院北院收治的24例间质性膀胱炎患者。所有患者被随机分为透明质酸钠（HA）与肝素钠+利多卡因（HL）两组，均采用膀胱水扩张后联合膀胱内灌注治疗，并在之后进行每3个月一次、维持12个月的随访。从每日排尿次数、盆腔疼痛的视觉评分指数（VAS）等方面进行各组治疗前后、组与组之间的比较。结果  24例患者均完成了随访,并在治疗过程中未发生明显的灌注并发症。在缓解率上，仅在12个月时两组之间的完全缓解率差异有统计学意义（HA组4/13对HL组2/11，P<0.05）。在症状控制上，两组患者在治疗初期尿频、尿急及下腹疼痛均改善明显，但在12个月的随访时间点上，HL组的每日排尿次数及VAS疼痛评分与治疗前差异无统计学意义（P>0.05），而HA组依然能保持一定的疗效，两组之间差异有统计学意义（P<0.05）。结论  透明质酸钠灌注治疗间质性膀胱炎在症状控制方面效果更持久，可长达12个月，优于肝素钠+利多卡因灌注治疗。

关键词: 间质性膀胱炎, 透明质酸钠, 膀胱水扩张

Abstract:

Objective  To explore the therapeutic effect and prognosis of treating patients with interstitial cystitis by intravesical hyaluronic acid instillation and heparin-lidocaine instillation. Methods  A total of 24 patients with interstitial cystitis who were admitted in Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine from February 2013 to April 2015 were selected. The patients, randomly divided into hyaluronic acid (HA) group and heparin sodium-lidocaine (HL) group, underwent the intravesical chemotherapy after bladder hydrodistention, and were followed up every 3 months for 12 months. Frequency of daily voiding and vision analogue scale (VAS) of pelvic pain of two groups before and after treatment were compared. Results  All 24 patients completed the follow-up and no obvious complications of intravesical instillation were recorded during the course of treatment. For the remission rate, only the complete remission rates of two groups by the end of 12 months were significantly different (HA group was 4/13 and HL group was 2/11, P<0.05). For symptom control, the urinary frequency, urinary urgency, and subabdominal pain of both groups were significantly alleviated at the early phase of treatment. But at the time point of 12 months after instillation, the differences of frequency of daily voiding and VAS of HL group before and after treatment were not statistically significant (P>0.05), while the therapeutic effect of the HA group remained. The difference between two groups was statistically different (P<0.05). Conclusion  The effect of treating interstitial cystitis by hyaluronic acid intravesical instillation lasts 12 months in terms of symptom control and is better than that of treating interstitial cystitis by heparin sodium-lidocaine intravesical instillation.

Key words: interstitial cystitis, hyaluronic acid, bladder hydrodistention