Traxer O, Desgrandchamps F, Sebe P, Haab F, Le Duc A, Gattegno B, Thibault P
Service d'Urologie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris.
Prog Urol. 2001 Sep;11(4):591-601.
Haemorrhagic cystitis consists of acute or insidious diffuse bleeding from the bladder mucosa. Although the aetiology of haemorrhagic cystitis is varied, the two predominant causes are chemical and irradiation. The chemical compounds most frequently responsible for haemorrhagic cystitis are oxaphosphorines (cyclophosphamide, ifosfamide). Haemorrhagic cystitis may also be due to toxic or infectious causes (bacterial, fungal, parasitic or viral). Finally, haemorrhagic cystitis can occur in the context of a systemic disease or may be isolated and idiopathic. Prevention of haemorrhagic cystitis, based on general measures and specific measures, is essential, but is not always effective. In the case of proven haemorrhagic cystitis, various treatment options are available, including and can associate clot extraction, continuous bladder irrigation, bladder instillations of haemostatic factors, formalin, hyperbaric oxygen therapy, arterial embolization or salvage surgery. Although therapeutic management is usually effective, it can sometimes be difficult due to the severity of the bleeding and its repercussions on the patient's general state. Deaths are not exceptional, emphasizing the seriousness of haemorrhagic cystitis. Based on a review of the literature, the authors review the aetiology and treatment of haemorrhagic cystitis.
出血性膀胱炎表现为膀胱黏膜急性或隐匿性弥漫性出血。尽管出血性膀胱炎的病因多种多样,但两个主要原因是化学因素和辐射。最常导致出血性膀胱炎的化学化合物是氧磷类药物(环磷酰胺、异环磷酰胺)。出血性膀胱炎也可能由毒性或感染性原因(细菌、真菌、寄生虫或病毒)引起。最后,出血性膀胱炎可发生在全身性疾病的背景下,也可能是孤立的、特发性的。基于一般措施和特定措施预防出血性膀胱炎至关重要,但并不总是有效。对于已确诊的出血性膀胱炎,有多种治疗选择,包括并可联合血块清除、持续膀胱冲洗、膀胱内注入止血因子、福尔马林、高压氧治疗、动脉栓塞或挽救性手术。尽管治疗管理通常有效,但有时由于出血的严重程度及其对患者总体状况的影响,治疗可能会很困难。死亡并不罕见,这凸显了出血性膀胱炎的严重性。基于对文献的回顾,作者对出血性膀胱炎的病因和治疗进行了综述。