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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李建達 | 經尿道切除術及膀胱水擴張術做為治療潰瘍型間質性膀胱炎的效果 | 2013/12/30 上午 11:11:33 | 0 |
| 原 文 | 題 目 | Effect of transurethral resection with hydrodistention for the treatment of ulcerative interstitial cystitis |
| 作 者 | Lee ES, Lee SW, Lee KW, Kim JM, Kim YH, Kim ME | |
| 出 處 | Korean J Urol. 2013 October; 54(10): 682–688. | |
| 出版日期 | ||
| 評 論 |
目的：有很多治療間質性膀胱炎(Interstitial cystitis, IC)的方法來減輕病人的症狀，但是至今並沒有使用經尿道切除術合併膀胱水擴張術來治療潰瘍型IC的報告。 材料與方法：於是本文作者自2006年6月至2011年6月共收集了87位女性的IC病患，至少追蹤12個月，評估經尿道切除潰瘍合併膀胱擴張術的治療成效，比較方式以病人術前及術後的三天小便日誌和疼痛症狀指數(VAS)來評估；治療的滿意度則以整體反應面向(GRA)來計算。 結果：根據平均年齡59.1±10.1歲的87位女性患者追蹤平均26.7±14.4個月之結果，第一個月最大有效膀胱的儲尿量由平均168.4±92.4毫升上升至平均276.3±105.4毫升，12個月後則為平均227.3±91.7毫升；術後第一個月平均排尿次數則由原本17.2±8.5次下降到10.6±5.3次，然而12個月後卻上升至13.3±4.8次；十分制疼痛症狀指數在第一個月時由平均9.1±0.8分下降為1.2±0.3分並陸續增加至2.5±0.4分(第三個月)、3.2±0.4分(第六個月)、5.3±0.5分(第十二個月)。以GRA評估的症狀在第一個月時87位病患中有83位有改善情形(95.4%)而第十二個月時，87位病患中則有55位有改善情形(63.2%)。 結論：基於經尿道切除潰瘍及膀胱水擴張術可有效改善患者排尿次數及疼痛的情形，該方法可視為治療潰瘍性IC的有效方式之一。 |
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| abstract |
OBJECTIVES: Many treatment options to help relieve the symptoms of interstitial cystitis (IC) are available, but none are effective. Because no reports of transurethral ulcer resection with hydrodistention are available, we assessed the effects of such combined surgery for ulcerative IC. METHODS: Between June 2006 and June 2011, 87 female patients with IC who underwent transurethral resection with hydrodistention and were followed up for at least 12 months were included. Improvements in patients voiding symptoms and pain were analyzed retrospectively by using a 3-day micturition chart and a 10-point visual analogue scale (VAS) before and after the operation. The global response assessment (GRA) was used to assess treatment satisfaction. RESULTS: The mean age of the 87 female patients was 59.1±10.1 years, and the mean follow-up period was 26.7±14.4 months. Mean maximum functional bladder capacity increased from 168.4±92.4 mL to 276.3±105.4 mL (1 month) and to 227.3±91.7 mL (12 months). The mean frequency of voiding decreased from 17.2±8.5 before to 10.6±5.3 after (1 month) surgery; however, it increased again to 13.3±4.8 at 12 months. The 10-point VAS score decreased from 9.1±0.8 to 1.2±0.3 (1 month); however, it increased again to 2.5±0.4 (3 months), 3.2±0.4 (6 months), and 5.3±0.5 (12 months) (p<0.001). Symptom improvement based on the GRA was observed in 83 of the 87 patients (95.4%) at 1 month and in 55 of 87 patients (63.2%) at 12 months. CONCLUSIONS: Transurethral resection with hydrodistention is an effective treatment option for ulcerative IC because it provides improvements in voiding symptoms and pain. |
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