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相關文獻
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題名 | 令內外科醫生都困惱的疾病--間質性膀胱炎=Interstitial Cystitis |
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作者 | 沈振榮; 陳錫斌; | 書刊名 | 內科學誌 |
卷期 | 10:4 1999.08[民88.08] |
頁次 | 頁126-132 |
分類號 | 415.835 |
關鍵詞 | 間質性膀胱炎; Interstitial cystitis; |
語文 | 中文(Chinese) |
中文摘要 | 間質性膀胱炎是一症候群,結合多種症狀,包括頻尿、夜尿、尿急、膀胱腫漲 ,和恥骨上區疼痛。傳統尿液細菌和細胞學檢查,皆無發現。其病因和致病機轉至今未明 ,神經性發炎是目前較受重視之理論,此乃基於組織病理發現:膀胱壁呈現明顯的神經纖 維增殖,和慢性的神經束膜炎;而間質性膀胱炎之症狀,又可以用此理論解釋。電子顯微 鏡的發現亦似乎頗能支持此理論。 間質性膀胱炎的診斷性評估包括:尿液分析,細胞學,微生物,膀胱鏡檢查。對於具 有臨床症狀者,當其處於麻醉下且膀胱被充水擴張後,存有膀胱黏膜下出血,或亨納氏潰 瘍時,則病人可能是間質性膀胱炎病患。在1987年,NIH發表間質性膀胱炎的診斷標準。 雖然此診斷標準並沒有得到所有專家一致認同,但卻為後學者提供一研究標準。 在治療方面,許多方法如:膀胱充水、灌注DMSO、heparin、elmiron,都被試用,但 仍未有一致認同的有效治療方法。 |
英文摘要 | Interstitial cystitis (IC) is a condition characterized by various combinations of urinary frequency, nocturia, urgency, suprapubic pressure, bladder/pelvic pain. Conventional urine culture and cytology studies are negative. The etiology and pathogenesis are essentially unknown. The proposal of neurogenic inflammation is though to be the primary pathogenic factor. This theory is based on the new histopathologic findings: prominent neuroproliferation and chronic perineuritis in the bladder wall, and is reinforced by the fact that the pain and urinary frequency/urgency are cardinal features of the disease. The new findings of electron microscopy also supple this theory. The diagnostic evaluation should include urinalysis, cytology, microbiology, and cystoscope. The presence of submucosal hemorrhage after bladder distension in an anesthetized patient, or the presence of a Hunner's ulcer, is considered to be diagnostic for IC in patients who have the symptom complex. In 1987, the NIH convened workshops to develop diagnostic criteria for a research definition of IC. Although some investigators do not agree the criteria, it doses offer a research definition for others. Numerous therapies for IC are used, such as bladder hydrodistention, bladder instillation with DMSO, heparin, or elmiron, but a uniformly effective therapy for this condition still lack. (J Intern Med Taiwan 1999;10:126-132) |
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