输尿管布比卡因灌注治疗腰腹痛血尿综合征。
Ureteric bupivicaine infusion for loin pain haematuria syndrome.
作者信息
Ahmed M, Acher P, Deane A M
机构信息
Department of Urology, Kent and Canterbury Hospital, Canterbury, UK.
出版信息
Ann R Coll Surg Engl. 2010 Mar;92(2):139-41. doi: 10.1308/003588410X12628812458338.
INTRODUCTION
Loin pain haematuria syndrome is a common problem with complications including opiate dependence. Morbidity treatments include intra-ureteric capsaicin infusion, nephrectomy, autotransplantation and nephrolysis. We explored the use of flexible cystoscopic infusion of intra-ureteric bupivicaine.
PATIENTS AND METHODS
Patients presenting with chronic loin pain underwent urological and nephrological evaluation. Bupivicaine (0.5%, 20 ml) was infused via an intra-ureteric catheter under flexible cystoscopic guidance. Repeat infusions were offered if indicated.
RESULTS
Sixteen of 17 patients with 1-year follow-up responded and were satisfied. Twelve of these required repeat infusions (mean, 2.9 infusions). The procedures were well tolerated by all patients without adverse effects.
CONCLUSIONS
Intra-ureteric bupivicaine infusion has a place in the management of patients with chronic renal pain. It offers a minimally invasive alternative to other treatments. This procedure warrants further investigation within a randomised, controlled trial setting.
引言
腰背痛血尿综合征是一个常见问题，其并发症包括阿片类药物依赖。治疗方法包括输尿管内注入辣椒素、肾切除术、自体肾移植术和肾松解术。我们探讨了在软性膀胱镜引导下输尿管内注入布比卡因的应用。
患者与方法
出现慢性腰背痛的患者接受了泌尿外科和肾脏病学评估。在软性膀胱镜引导下，通过输尿管内导管注入布比卡因（0.5%，20毫升）。如有必要，可进行重复注入。
结果
17例患者中有16例接受了1年随访，反应良好且满意。其中12例需要重复注入（平均2.9次注入）。所有患者对这些操作耐受性良好，无不良反应。
结论
输尿管内注入布比卡因在慢性肾痛患者的治疗中占有一席之地。它为其他治疗提供了一种微创替代方法。该操作值得在随机对照试验环境中进一步研究。
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