预防膀胱肿瘤术后复发的临床研究  

Prevention of postoperative recurrence of bladder cancer: a clinical study

作　　者：杨德安[1] 李慎勤[1] 王洪伟[1] 李香铁[1] 刘少鸽[1] 韩玮[1] 郝俊文[1] 张海滨[1] 

机构地区：[1]济南军区总医院泌尿外科,250031

出　　处：《中华外科杂志》1999年第8期464-465,共2页Chinese Journal of Surgery

摘　　要：目的　探讨不同方法预防膀胱肿瘤术后复发的效果，降低膀胱肿瘤复发率。　方法　对１９８２ ～１９９７ 年间采用膀胱灌注 Ｂ Ｃ Ｇ、丝裂霉素 Ｃ（ Ｍ Ｍ Ｃ） 、噻替哌、口服中药猪苓煎剂、后装腔内放疗５ 种不同方法预防膀胱肿瘤复发，评价其效果。　结果　随访２ ～１５ 年，其复发率分别为 Ｂ Ｃ Ｇ 组３５１ ％ ，猪苓组３４９ ％ ， Ｍ Ｍ Ｃ 组４１７ ％ ，噻替哌组５２６ ％ ，空白对照组６４７ ％ 。后装放疗组处理高危性膀胱癌２５ 例，随访１２ ～４２ 个月，复发率２４０ ％ 。　结论　预防膀胱肿瘤复发的效果， Ｂ Ｃ Ｇ 和猪苓最好， Ｍ Ｍ Ｃ 次之，噻替哌效果不显著，后装腔内放疗对某些高危性膀胱癌值得应用。Objective To lower postoperative recurrence rate of bladder cancer,the prophylactic effects of five kinds of method on bladder cancer were evaluated. Methods Between 1982 and 1997, 313 patients after TURBT or partial cystectomy were followed up for 2 to 15 years (average 7 6 years). These patients were divided into six groups: BCG,mytomycin C (MMC), thiotepa, Chinese herb medicine Zhuling (Grifola umbellata pilat),afterloading brachytherapy and control group. The prophylactic effects of them on postoperative recurrence of bladder cancer was evaluated. Results During the follow up, the recurrence rates were 35 1% in BCG group,34 9% in Zhuling group, 41 7% in MMC group, 52 6% in thiotepa group, 64 7% in control group,respectively. 25 high risk patients with invading or multiple bladder cancer were treated by afterloading brachytherapy.They were followed up from 12 to 42 months,with a recurrence rate being 24 0%. Conclusions The prophylactic effect of Zhuling and BCG on bladder cancer recurrence was better than MMC. The vale of thiotepa was not significant. The afterloading brachytherapy was of great vale to invading or recurrent, multiple bladder cancer.

关 键 词：膀胱肿瘤 卡介苗 猪苓 预防 手术后 复发 

分 类 号：R737.140.1[医药卫生—肿瘤]