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目的观察对女性间质性膀胱炎采用3种不同方法治疗的疗效及其对生活质量的影响。方法将2011年1月至2014年1月67例女性间质性膀胱炎患者随机分为A、B、C 3组,其中A组25例,予单纯口服阿米替林药物治疗;B组26例,予口服阿米替林和膀胱灌注肝素钠治疗;C组16例,予膀胱液压扩张与膀胱逼尿肌内注射肉毒素A治疗。治疗3个月后比较3组的疗效、排尿次数、最大膀胱容量、间质性膀胱炎症状指数(ICSI)、盆腔疼痛和尿频评分(PUF)及生活质量的情况。结果治疗3个月后,症状显著缓解率由高到低依次为C组100%,B组76.9%,A组44.0%(P<0.01);C组排尿次数/24 h、夜尿次数、最大膀胱容量、ICSI、PUF均优于A、B组(P<0.05或P<0.01);生活质量评分由低到高(即生活质量由好到差)依次为C组(1.3±0.6)分,B组(2.4±1.1)分,A组(3.2±1.8)分(P均<0.05)。结论膀胱逼尿肌内注射肉毒素A是临床上比较新的治疗方案,联合膀胱液压扩张术能明显缓解症状,提高生活质量。
Objective To observe the effects of three different treatments on female interstitial cystitis and their effects on quality of life. Methods From January 2011 to January 2014, 67 cases of interstitial cystitis in women were randomly divided into A, B and C groups, of which 25 cases in group A were treated with amitriptyline alone. Group B Cases, oral amitriptyline and intravesical instillation of heparin sodium treatment; C group of 16 cases, to the bladder hydraulic dilatation and detrusor intravesical injection of botulinum toxin A treatment. After 3 months of treatment, the curative effect, frequency of urination, maximum bladder capacity, ICSI, pelvic pain and urinary frequency score (PUF) and quality of life were compared among the three groups. Results After 3 months of treatment, the symptom relief rate was 100% in group C, 76.9% in group B and 44.0% in group A (P <0.01). The frequency of micturition / 24 h, the number of nocturia in group C was the highest The bladder volume, ICSI and PUF were superior to those of the A and B groups (P <0.05 or P <0.01). The quality of life scores from low to high (ie, good to poor quality of life) were C (1.3 ± 0.6) Group B (2.4 ± 1.1), Group A (3.2 ± 1.8) points (P <0.05). Conclusion Intravesical instillation of Botulinum toxin A is a relatively new clinical treatment plan. Combined with bladder hydropower dilation can relieve symptoms and improve quality of life.