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高压氧治疗放射性出血性膀胱炎

[Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis].

作者信息

Miyazato T, Yusa T, Onaga T, Sugaya K, Koyama Y, Hatano T, Ogawa Y

机构信息

Department of Urology, Faculty of Medicine, University of The Ryukyus.

出版信息

Nihon Hinyokika Gakkai Zasshi. 1998 May;89(5):552-6. doi: 10.5980/jpnjurol1989.89.552.

Abstract

BACKGROUND

Radiation therapy has widely been used for cancers in the pelvis. Radiation cystitis, one of the late complications, presents often as hemorrhagic cystitis, which is refractory to the conventional therapy and may threaten the patient's life. We used hyperbaric oxygen therapy on patients with radiation cystitis to test its potential benifit.

METHODS

Ten patients aged from 46 to 81 years with a mean of 62 years underwent one or more courses of hyperbaric oxygen therapy according to their symptoms, consisting of 20 sessions (3 to 5 sessions a week) at the Department of Hyperbaric Medicine, the University of the Ryukyus Hospital in the 9-year period from 1985 to 1994. They included 8 patients having a history of cervical cancer, one with external genital cancer and one with vaginal cancer. During the 75 min hyperbaric oxygen therapy patients received 100% oxygen at 2 absolute atmosphere pressure in the Multiplace Hyperbaric Chamber.

RESULTS

Hematuria subsided and subjective symptoms including urinary frequency improved in seven patients. Cystoscopic findings including mucosal edema, redness, and capillary dilation were partially improved. The procedure subjectively and objectively palliated the 10 patients in a favorable manner.

CONCLUSIONS

To date we have not armed any active procedure to control radiation-induced refractory hemorrhagic cystitis in terms of efficacy, invasiveness, and adverse effects. Therefore, in consideration of our clinical results, hyperbaric oxygen therapy appears to be useful for radiation cystitis.

摘要

背景

放射治疗已广泛应用于盆腔癌症。放射性膀胱炎是晚期并发症之一,常表现为出血性膀胱炎,传统治疗方法对此难以奏效,且可能危及患者生命。我们对放射性膀胱炎患者采用高压氧治疗,以测试其潜在益处。

方法

1985年至1994年的9年间,10例年龄在46至81岁(平均62岁)的患者,根据症状接受了一个或多个疗程的高压氧治疗,治疗在琉球大学医院高压医学科进行,共20次(每周3至5次)。其中8例有宫颈癌病史,1例有外阴癌病史,1例有阴道癌病史。在75分钟的高压氧治疗过程中,患者在多人高压舱内2个绝对大气压下吸入100%氧气。

结果

7例患者血尿消退,包括尿频在内的主观症状有所改善。膀胱镜检查发现,如黏膜水肿、发红和毛细血管扩张等情况部分得到改善。该治疗方法在主观和客观上都使10例患者病情得到了良好缓解。

结论

就疗效、侵袭性和不良反应而言,目前尚无任何积极有效的方法来控制放射性难治性出血性膀胱炎。因此,鉴于我们的临床结果,高压氧治疗似乎对放射性膀胱炎有用。

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