Department of Urology, Fujian Provincial Cancer Hospital, Fuzhou, China.
Department of Invasive Technology, Fujian Provincial Cancer Hospital, Fuzhou, China.
Int J Med Sci. 2021 Jan 1;18(3):756-762. doi: 10.7150/ijms.47906. eCollection 2021.
Curing hemorrhagic cystitis remains a challenge. We explore a continuous and effective treatment for hemorrhagic radiation cystitis. The data of patients in 6 provincial cancer hospital urology departments between April 2015 and December 2019 was reviewed retrospectively. Patients were classified as moderate and severe groups. The 5-steps sequential method was adopted. Two groups were initiated with step 1 and step 3 respectively. Step 1 was symptomatic treatment. Thrombin solution or sodium hyaluronate was administrated for bladder irrigation in step 2. Step 3 was transurethral electrocoagulation. Step 4 was interventional embolization. Step 5 was HBO therapy. OABSS was used to assess the improvement of patients' symptoms. The outcome was evaluated after at least 6 months of follow-up. A total of 650 patients (56 men and 594 women), mean age 71.2 years, were enrolled in the 5 steps sequential method. 582 patients were classified as moderate and 68 severe group. In moderate group, the cure rate of step 1 was 61.2% (356/582), 80.4% (468/582) after step 2, 93.1% (542/582) after step 3, 96.2% (560/582) after step 4, and 99.8% (581/582) after step 5. In severe group, the cure rate was 54.4% (37/68) after step 3, 76.5% (52/68) after step 4, and 94.1% (64/68) after the step 5 respectively. The mean OABSS scores of both groups significantly decreased after 5 steps sequential method treatment (P<0.01). Our results show hemorrhagic radiation cystitis can be cured in 5 steps, and the 5 steps sequential method is welcomed and effective. Therapy efficacy depends on the number of steps adopted and the severity of hematuria.
治疗出血性膀胱炎仍然是一个挑战。我们探索一种连续有效的治疗出血性放射性膀胱炎的方法。回顾了 2015 年 4 月至 2019 年 12 月 6 家省级癌症医院泌尿科患者的数据。患者分为中度和重度两组。采用五步序贯法，两组分别从第一步和第三步开始。第一步是对症治疗。第二步膀胱灌洗时给予凝血酶溶液或透明质酸钠。第三步是经尿道电凝。第四步是介入栓塞。第五步是 HBO 治疗。采用 OABSS 评估患者症状改善情况。至少随访 6 个月后进行疗效评价。共纳入 650 例患者（男 56 例，女 594 例），平均年龄 71.2 岁，采用五步序贯法。582 例为中度组，68 例为重度组。在中度组中，第一步的治愈率为 61.2%（356/582），第二步后为 80.4%（468/582），第三步后为 93.1%（542/582），第四步后为 96.2%（560/582），第五步后为 99.8%（581/582）。在重度组中，第三步后治愈率为 54.4%（37/68），第四步后为 76.5%（52/68），第五步后为 94.1%（64/68）。两组患者在接受五步序贯法治疗后 OABSS 评分均明显降低（P<0.01）。我们的结果表明，出血性放射性膀胱炎可以通过五步序贯法治愈，且该方法受到欢迎并有效。治疗效果取决于采用的步骤数和血尿的严重程度。
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