术中黏膜下注射氮芥与术后即刻灌注吡柔比星预防非肌层浸润性膀胱癌术后复发的临床研究  

Clinical research between intraoperative bladder submucosal acid itrogen mustard and postoperative immediate instillation ting non muscle invasive bladder tumor recurrence injection of hydrochloric of pirurubicin for preven-

作　　者：皮硕煌[1] 何本林 杨军[1] 谢国欣 文小波[1] 

机构地区：[1]石门县人民医院泌尿外科,湖南415300

出　　处：《国际泌尿系统杂志》2013年第4期504-506,共3页International Journal of Urology and Nephrology

摘　　要：目的探讨比较经尿道膀胱肿瘤电切（TUR—Bt）术中膀胱黏膜下注射盐酸氮芥与术后即刻灌注吡柔比星（THP）化疗预防非肌层浸润性膀胱癌复发的疗效。方法将64例行TUR—Bt术的膀胱癌患者随机分为A、B两组，A组34例术中膀胱黏膜下注射盐酸氮芥；B组30例于手术后采用吡柔比星膀胱灌注。观察各组肿瘤复发情况、毒副反应。结果A组平均随访37．1个月，4例复发，复发率11．8％；B组平均随访36．2个月，7例复发，复发率23．3％，两组之间差异有统计学意义（P〈O．05）。所有患者未见明显的全身性药物反应。结论术中黏膜下注射盐酸氮芥和术后早期膀胱灌注吡柔比星显著降低非肌层浸润性膀胱癌术后复发率，其中术中黏膜下注射优于术后早期灌注，两组之间副作用无明显差异。Objectives To investigate the preventive efficacy of intraoperative bladder submucosal injec- tion of hydrochloric acid nitrogen mustard and postoperative immediate instillation of pirurubicin for the recurrence of bladder cancer irt the transurethral resection of the bladder tumor （ TUR - Bt）. Methods All the 42 patients with bladder cancer treated with TUR - Bt were randomly divided into two groups, group A and group B. Hydrochloric acid nitrogen was injected submucously during operation to patients in group A; Patients in group B received immedi- ate instillation of pirurubicin. The recurrence rates and side effects after treatment were evaluated. Results The recurrence rates of group A （ mean follow up of 37.1 months） was 15% ; The recurrence rates of group B （ mean fol- low up of 36.2 months） was 31.8%, the difference was statistically significant （ P 〈 0. 05 ）. No systemic side effect had been observed in all patients. Conclusions Intraoperative bladder submucosal injection of hydrochloric acid nitrogen mustard and postoperative immediate instillation of pirurubicin can both effectively reduce the recurrence rate o f superficial bladder tumor, but the former is more effective. No significant difference was found in side effects between the two groups.

关 键 词：膀胱肿瘤 氮芥 表柔比星 

分 类 号：R737.14[医药卫生—肿瘤]