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目的:探讨内镜下电灼术治疗溃疡型膀胱疼痛综合征/间质性膀胱炎患者(bladder pain syndrome/interstitial cystitis;BPS/IC)的临床有效性和安全性。方法:所有患者在膀胱镜检+水扩张后,病理回报明确为非特异性炎症者,排除恶性肿瘤疾病,明确为BPS/IC诊断后,分为溃疡型和非溃疡型。随机选取32例溃疡型BPS/IC患者行膀胱溃疡内镜下电灼术治疗。观察手术治疗前后(术后随访1、3、6个月)病情变化如:临床症状情况(每日排尿次数、最大排尿容量、膀胱区疼痛程度评分)和O’Leary-Sant间质性膀胱炎问卷表评分及生活质量评分(QOL)情况。结果:32例溃疡型BPS/IC患者,男5例,女27例,年龄36～60岁,平均(47.0±6.2)岁;病程1～5年,平均(3.5±1.2)年。本组患者症状改善总有效率78.1%(25/32),其中完全缓解率为53.1%(17/32),部分缓解率为25%(8/32),治疗无效率为21.9%(7/32)。手术治疗后患者平均每日排尿次数、每次排尿量、疼痛程度、O’Leary-Sant评分、生活质量评分与治疗前相比均存在显著改善(P<0.01)。结论:内镜下电灼术治疗溃疡型BPS/IC患者能够有效缓解临床症状和改善生活质量。
Objective: To investigate the clinical efficacy and safety of endoscopic electrosurgery in the treatment of bladder pain syndrome / interstitial cystitis (BPS / IC). Methods: All patients underwent cystoscopy + water expansion, the pathological findings were clearly non-specific inflammation, excluding malignant disease, clear for the BPS / IC diagnosis, divided into ulcer and non-ulcer type. Thirty-two patients with ulcerated BPS / IC were randomly selected for endoscopic treatment of bladder ulcer. The changes of the patients before and after operation (1, 3, and 6 months after operation) were observed. The clinical symptoms (number of urination per day, maximum voiding capacity, pain score of bladder area) and O’Leary-Sant interstitial cystitis Questionnaire score and quality of life score (QOL). Results: In 32 patients with ulcerative type BPS / IC, there were 5 males and 27 females. The average age was 36.0 ± 6.2 years. The duration of disease ranged from 1 to 5 years (average, 3.5 ± 1.2) years. The total effective rate was 78.1% (25/32) in this group, of which the complete remission rate was 53.1% (17/32), the partial remission rate was 25% (8/32) and the treatment inefficiency was 21.9% (7 / 32). The average daily urination frequency, urination volume, pain degree, O’Leary-Sant score and quality of life score of patients after operation were significantly improved (P <0.01). Conclusion: Endoscopic cautery for the treatment of ulcerative BPS / IC patients can effectively relieve clinical symptoms and improve quality of life.