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目的:总结女性腺性膀胱炎的临床特点和治疗方法。方法:对97例腺性膀胱炎患者的临床诊治资料进行回顾分析。97例患者年龄23~79岁,平均49.6岁。主要临床症状:尿频、尿急、尿痛37例,血尿24例,膀胱刺激症状伴血尿12例,下腹痛9例,排尿困难8例,无症状经体检发现3例。反复尿路感染或尿常规、尿培养提示感染45例,合并膀胱颈口抬高14例。先期病变为膀胱移行细胞癌,术后9个月发现腺性膀胱炎2例。所有患者均经膀胱镜活检或手术标本病理检查证实为腺性膀胱炎。结果:病变位于膀胱三角区、膀胱颈口86例,膀胱侧壁3例,后壁6例,顶部2例。病变呈滤泡状41例,乳头状23例,绒毛状12例,炎症改变13例,黏膜无显著改变8例。9例给予保守治疗,4例获得随访,时间为3个月~2年,抗感染治疗后症状缓解;88例行手术治疗,全部行经尿道等离子电切术,70例获得随访,时间为8个月~9年,66例未见复发,4例复发,复发间隔时间:13~20个月,平均15.5个月。复发患者1例保守治疗,未行手术,3例再次给予手术治疗,均再次行经尿道等离子电切术。结论:女性腺性膀胱炎多伴有尿路感染及膀胱颈梗阻,病变多较轻,经尿道等离子电切是简单、有效的治疗方法,预后良好。
Objective: To summarize the clinical features and treatment of female cystitis glandularis. Methods: The clinical data of 97 patients with glandular cystitis were retrospectively analyzed. 97 patients aged 23 to 79 years, mean 49.6 years old. The main clinical symptoms: urinary frequency, urgency, dysuria in 37 cases, hematuria in 24 cases, bladder irritation with hematuria in 12 cases, lower abdominal pain in 9 cases, dysuria in 8 cases, asymptomatic findings by physical examination in 3 cases. Repeated urinary tract infection or urinary routine, urine culture prompted infection in 45 cases, combined with bladder neck up 14 cases. Preneoplastic lesions of bladder transitional cell carcinoma, 9 months after the discovery of cystitis cystitis in 2 cases. All patients were confirmed cystitis by cystoscopy biopsy or surgical specimen pathology. Results: The lesion was located in the trigone of bladder with 86 cases of bladder neck, 3 cases of bladder wall, 6 posterior wall and 2 cases of top. The lesions were follicular in 41 cases, papillary in 23 cases, villous in 12 cases, inflammatory changes in 13 cases, no significant change in mucosa in 8 cases. Nine patients were given conservative treatment and four patients were followed up for 3 months to 2 years. The symptoms were relieved after anti-infective therapy. Eighty-eight patients underwent surgical resection and all of them underwent transurethral resection of the urethra. 70 patients were followed up for 8 months Month ~ 9 years, 66 cases no recurrence, 4 cases of recurrence, recurrence interval: 13 to 20 months, an average of 15.5 months. One case of recurrent patients conservative treatment, no surgery, three cases were given surgical treatment, are again underwent transurethral resection of plasma. Conclusion: Female cystitis glandula often accompanied by urinary tract infection and bladder neck obstruction, lesser lesions, transurethral plasma tangential is a simple and effective treatment, the prognosis is good.