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目的:探讨RTX膀胱灌注治疗氯胺酮相关性下尿路症状的有效性和安全性。方法:收治滥用氯胺酮1.5～6年患者16例,均因严重下尿路症状就诊,所有患者均行RTX 1次性膀胱灌注,观察用药前及用药后1周、1个月、3个月时患者的临床症状情况(每日排尿次数、排尿量、尿疼痛程度评分)和生活质量评分(QOL)情况。结果:患者用药前及用药后1周、1个月和3个月时每日排尿次数分别为(48.41±10.77)、(14.30±4.77)、(14.63±3.70)和(15.19±4.06)次,用药后排尿次数明显减少;最大排尿量分别为(104.26±79.31)、(167.41±67.46)、(188.89±62.35)和(171.85±65.11)ml,用药后排尿量增加;疼痛程度评分分别为(6.74±1.38)、(3.89±1.15)、(4.63±1.31)和(4.85±1.67)分,较用药前明显下降,上述指标与用药前相比差异有统计学意义。患者用药前后生活质量评分分别为(5.92±0.51)、(5.20±0.47)、(5.33±0.46)、(5.34±0.51)分,差异无统计学意义。所有患者均坚持完成试验,使用RTX后患者生命体征均平稳,无全身不良反应。结论:用RTX膀胱灌注治疗能有效缓解氯胺酮相关性下尿路症状患者的临床症状和改善其生活质量,且耐受性及安全性好。
Objective: To investigate the effectiveness and safety of intravesical instillation of RTX in the treatment of ketamine-associated lower urinary tract symptoms. Methods: Totally 16 patients with abuse of ketamine from 1.5 to 6 years were enrolled in the study because of severe lower urinary tract symptoms. All patients underwent RTX one-time intravesical instillation. One week, one month and three months after treatment were observed. The patient’s clinical condition (number of urination, urine output, degree of urinary pain) and quality of life (QOL) were analyzed. Results: The urinary frequency of urination was (48.41 ± 10.77), (14.30 ± 4.77), (14.63 ± 3.70) and (15.19 ± 4.06) times before treatment and 1 week, 1 month and 3 months after treatment, The number of micturition significantly decreased after treatment. The maximum micturition rates were (104.26 ± 79.31), (167.41 ± 67.46), (188.89 ± 62.35) and (171.85 ± 65.11) ml respectively. Urine volume increased after treatment. The pain scores were (6.74 ± 1.38), (3.89 ± 1.15), (4.63 ± 1.31) and (4.85 ± 1.67) points, respectively, which were significantly lower than those before treatment. The above indexes were significantly different from those before treatment. The quality of life scores of patients before and after treatment were (5.92 ± 0.51), (5.20 ± 0.47), (5.33 ± 0.46) and (5.34 ± 0.51), respectively, with no significant difference. All patients insisted on completing the test, patients using RTX vital signs were stable, no systemic adverse reactions. CONCLUSION: Intravesical instillation of RTX can effectively relieve the clinical symptoms and improve the quality of life of patients with lower urinary tract symptoms associated with ketamine, with good tolerability and safety.