经尿道膀胱肿瘤选择性绿激光汽化术联合表柔比星治疗非肌层浸润性膀胱癌的临床研究  

Clinical research of superficial bladder cancer treated with Greenlight laser photoselective vaporization and epirubicin

作　　者：张继红[1] 张廷继[2] 侯瑞鹏[2] 

机构地区：[1]天津市人民医院药学部,天津300121 [2]天津市人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2015年第1期31-33,共3页Journal of Clinical Urology

摘　　要：目的 探讨经尿道膀胱肿瘤选择性绿激光汽化术（PVBT）后辅助表柔比星（EPI）膀胱灌注治疗非肌层浸润性膀胱癌（NMIBC）的临床效果及安全性。方法：回顾性分析2010年1月～2013年6月收治的156例NMIBC患者的临床资料：男119例，女37例，年龄36--85岁，平均60．2岁。初诊肿瘤147例，复发肿瘤9例；单发肿瘤52例，多发肿瘤104例。术前均行膀胱镜活检组织病理检查确诊。腰椎管麻醉或全麻后，采用非接触式PVBT，额定输出汽化功率为80w，电凝功率为30w。术后常规留置导尿管3～5天。术后24小时内给予首次膀胱灌注EPI为50mg，以后规律性灌注且持续维持1年。全部患者术后均定期随访。结果：本组156例患者的全部肿瘤均成功切除。手术时间30～75min，平均35min；术中出血〈10ml，未发生膀胱穿孔。全部患者均完成EPI膀胱灌注化疗。随访时间3～32个月，平均21．3个月。术后发生肿瘤复发18例，复发率为11．5％。结论：PVBT联合EPI膀胱灌注治疗NMIBC创伤小，出血少，安全性高且术后复发率低，是较为理想的治疗方法之一。Objective： To discuss the clinical efficacy and safety of photoselective vaporization for bladder tumor （PVBT） sequentially combined with epirubicin （EPI） intravesical instillation for non-muscle invasive bladder cancer （NMIBC）. Method： Clinical data of 156 patients with NMIBC from January 2010 to June 2013 were retrospectively analyzed, including 119 males and 37 females with average age of 60.2 years old. Among the cases, 147 cases were newly diagnosed and nine cases relapsed. Single tumor was found in 52 cases, and 104 cases were found multiple tumors. The cystoscopic biopsy for pathology examination was conducted preoperatively for diagnosis. After lumbar anesthesia or general anesthesia, the noncontaet Greenlight photoselective vaporization was adopted with rated output power of 80W and electric coagulation power of 30W. The urinary catheters were indwelled for 3-5 days postoperatively. Patients were firstly given EPI intravesical instillation of 50rag within 24 hours postoperatively and then also received the therapy regularly and continuously for a year. All patients were followed up periodically. Result： All the cases were performed with resection of tumors. The average operation time was 35 minutes. The surgical blood loss was less than 10ml. There was no bladder perforation or other severe complications occured. All patients completed the EPI intravesical instillation. The recurrence rate was 11.5% （18 cases） during the follow-up period of 3-32 months. Conclusion： Combination of PVBT with EPI intra- vesical instillation has advantages of little damage, little blood loss, safety and low recurrence for NMIBC.

关 键 词：膀胱肿瘤 癌 绿激光 手术 化疗 

分 类 号：R737.14[医药卫生—肿瘤]