CAJ | 학술논문

目的：总结膀胱黏膜白斑的诊断及治疗方法。方法：收集膀胱黏膜白斑患者123例，共93例完成随访，其中40例症状较轻者予药物治疗（药物组），53例症状较重者予经尿道电切术（手术组）。观察患者治疗后症状缓解情况以及膀胱镜检查情况。结果：93例患者治疗后随防6~72个月，平均34个月。手术组和药物组尿频、尿急缓解率分别为56%和60%，血尿缓解率分别为79%和65%，下腹胀痛缓解率分别为62%和76%。术后膀胱镜复查中，手术组膀胱镜无异常49例，9例病变范围较大累及膀胱颈，复发4例，2例经2次TUR治疗后痊愈；2例因复发范围较小，未行手术治疗，随访至今未见明显扩大。药物组37例未见病变范围扩大、恶化征象，3例膀胱病变好转甚至消失。93例中未发现癌变或进展为恶性肿瘤的病例。结论：病变轻微的膀胱黏膜白斑，手术及药物治疗效果相同；病变广泛者首选经尿道电切术治疗。
목적：총결방광점막백반적진단급치료방법。방법：수집방광점막백반환자123례，공93례완성수방，기중40례증상교경자여약물치료（약물조），53례증상교중자여경뇨도전절술（수술조）。관찰환자치료후증상완해정황이급방광경검사정황。결과：93례환자치료후수방6~72개월，평균34개월。수술조화약물조뇨빈、뇨급완해솔분별위56%화60%，혈뇨완해솔분별위79%화65%，하복창통완해솔분별위62%화76%。술후방광경복사중，수술조방광경무이상49례，9례병변범위교대루급방광경，복발4례，2례경2차TUR치료후전유；2례인복발범위교소，미행수술치료，수방지금미견명현확대。약물조37례미견병변범위확대、악화정상，3례방광병변호전심지소실。93례중미발현암변혹진전위악성종류적병례。결론：병변경미적방광점막백반，수술급약물치료효과상동；병변엄범자수선경뇨도전절술치료。
Objective To study the diagnosis,treatment and follow-up of leukoplakia of urinary bladder. Methods Ninety three patients with vescial leuko-plakia underwent medical or surgical were followed up treatment. Of all cases, 53 were treated by trans-urethral resection (surgical group) and 40 were treat-ed conservatively (medical group). In all of them, cys- toscopy was performed together with biopsy and histopathologic section which indicated metaplasia of the urothe-lium into nonkeratizing squamous multilayer urothelium. Results The patients were followed for 6~72 months, with an average of 34 months. The remission rate of frequent micturition,urgent micturition in surgical and medi-cal groups was 56.3% and 60.0 %, respectively.The remission rate of hematuria was 78.6 % and 64.7%, respec-tively. The remission rate of abdominal distention was 61.9% and 76.0%, respectively. Malignant transformation was not found in all patients. Conclusion Medical therapy is the first choice of treatment for the superficial lesions detected incidentally by biopsy, with the same satisfactory effect as surgery. For severe and extensive le-sions, transurethral resection should be preferably performed.The recurrence rate of leukoplakia of the bladder is low.