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目的评估膀胱内灌注透明质酸治疗顽固性非细菌性膀胱炎,缓解其尿路刺激症状的疗效及安全性。方法对20例顽固性非细菌性膀胱炎患者行膀胱内灌注透明质酸溶液治疗。男1例,女19例。年龄22～68岁,平均47岁。病程1个月～30年,其中＞1年者16例。治疗方法为1周1次×4次,然后4周1次×2次,随访至第16周。根据患者主观感受填写视觉模拟量表进行疗效评估并记录不良事件。治疗结果分为完全反应(症状消失或症状总分减少≥90%)、部分反应(症状总分减少50%～89%)、轻度反应(症状总分减少≤49%)和无反应(症状评分无改善)。结果除1例患者中途退出外,共19例患者完成了16周的随访,症状总分从平均22.32±5.53下降至9.47±5.88(P＜0.001),尿频评分从8.21±1.75下降至3.89±2.31(P＜0.001),尿急评分从7.47±2.14下降至3.37±2.14(P＜0.001),尿痛评分从6.63±3.47下降至2.21±2.74(P＜0.001)。第16周时总有效率(完全反应及部分反应)为53%(10/19)。除操作本身引起的不良反应如尿道刺激(25%,5/20)、膀胱胀痛加重(5%,1/20)和改变体位时引起的头晕(15%,3/20)外,未发现其他不良反应。结论膀胱内灌注透明质酸对顽固性非细菌性膀胱炎患者的尿路刺激症状有明显的改善作用,安全,依从性好。
Objective To evaluate the efficacy and safety of intravesical instillation of hyaluronic acid in treatment of intractable non-bacterial cystitis and relieve the urinary tract irritation. Methods Twenty patients with intractable non-bacterial cystitis underwent intravesical instillation of hyaluronic acid solution. 1 males and 19 females. Aged 22 to 68 years old, average 47 years old. Duration of 1 month to 30 years, of which> 1 year in 16 cases. Treatment for 1 week 1 × 4 times, then 4 times 1 times × 2 times, followed up to the first 16 weeks. According to subjective feelings of patients fill in the visual analog scale efficacy evaluation and record adverse events. The results were divided into complete response (symptom disappeared or symptom score decreased 90%), partial response (symptom score decreased 50% ~ 89%), mild reaction (symptom score reduced ≤ 49%) and no response No improvement in score). Results A total of 19 patients completed a 16-week follow-up except for one patient. The overall symptom score decreased from an average of 22.32 ± 5.53 to 9.47 ± 5.88 (P <0.001), and the urinary frequency score decreased from 8.21 ± 1.75 to 3.89 ± 2.31 (P <0.001). The urinary urgency score decreased from 7.47 ± 2.14 to 3.37 ± 2.14 (P <0.001) and the dysuria score decreased from 6.63 ± 3.47 to 2.21 ± 2.74 (P <0.001). The total effective rate (complete response and partial response) at week 16 was 53% (10/19). No adverse reactions such as urinary tract irritation (25%, 5/20), severe bladder pain (5%, 1/20), and dizziness (15%, 3/20) were noted when the operation itself was caused Other adverse reactions. Conclusion Intravesical instillation of hyaluronic acid has a significant effect on urinary tract irritation in patients with intractable non-bacterial cystitis, and its safety and compliance are good.