臭氧水膀胱腔内灌注治疗女性膀胱过度活动症疗效评价*

目的:评价臭氧水膀胱腔内灌注疗法对膀胱过度活动症的有效性和安全性。方法:2016年1月至2016年12月间共60例患者入组,所有患者均行尿流动力学检查证实膀胱逼尿肌不稳定。患者被随机分入治疗组(n=30)和对照组(n=30),对照组采用行为训练疗法并口服索利那新治疗。治疗组在行为训练疗法于口服索利那新的基础上,同时行臭氧水膀胱腔内灌注治疗。在治疗结束时通过患者病情改善情况评价疗效,主要评价指标包括:治疗前、后的患者24h排尿次数、平均夜尿次数、24h尿失禁次数、OABSS评分、I-QOL评分、治疗前和治疗结束末4周复查尿流动力学检查评估,并评估患者的不良反应。获得的数据采用t检验进行统计学分析。结果:结果证实,在24h排尿次数、平均夜尿次数、OABSS评分和I-QOL评分方面,各组治疗后有改善,而臭氧治疗组改善情况优于对照组(P0.05)。尿流动力学检查证实所有治疗后患者逼尿肌不稳定情况均有改善;初始尿意时膀胱容量、最大膀胱容量、储尿期膀胱逼尿肌最大压力变化情况治疗组改善优于对照组。不良反应由患者自主报告,治疗组主要表现为灌注后尿道内及下腹部不适感,多自主恢复,两组间差异不明显(P0.05)。结论:臭氧水膀胱腔内灌注治疗女性膀胱过度活动症安全、有效,能改善膀胱过度活动症患者排尿次数、夜尿次数和24小时尿失禁次数,能改善OABSS评分,能改善尿流动力学结果,提高患者的生活质量。

Ozone water Intravesical Instillation for Female Overactive Bladder: Initial Experience*

ABSTRACT Objective: To evaluate the efficacy and safety of ozone water intravesical instillation for female overactive bladder. Methods: 60 female patients with overactive bladder confirmed detrusor overactive by urodynamic evaluation were enrolled between January 2016 and December 2016. The patients were divided into control group (n=30) and ozone treatment group (n=30) randomly. All patients got basis therapy with bladder training and solifenacin and ozone treatment group got an extra ozone water intravesical instillation per week and last four weeks. We evaluated the average 24h-void time, average nighttime void, 24h-urgency incontinence, OABSS, I-QOL score via questionnaire before and 1 month later after-therapy, wo also did urodynamic evaluation for volume at first desire, maximal cystometric capacity, Pdetmax at storage before and 1 month later after-therapy. All statistical significances were determined by the Student''s t-test. Results: The data shew the average 24h-void time, average nighttime void, OABSS got decreased and I-QOL score got improvement compared before and 1 month later after-therapy in both groups(P<0.05). There was significant difference between ozone treatment group and control group (P<0.05). The urodynamic evaluation for volume at first desire, maximal cystometric capacity, Pdetmax got the same results. But there was no significant difference in 24h-urgency incontinence within two groups (P>0.05). The side effects was minor. Conclusion: Ozone water intravesical instillation for female overactive bladder is effective and safe with seldom side effects. It can reduce average 24h-void time, average nighttime void, OABSS, and can improve the I-QOL score, and results of urodynamic evaluation.