短周期重复电切联合吡柔比星治疗 T2期移行膀胱癌的临床研究  

A clinical research of short-cycle repeat transurethral resection combined pirarubicin treatment of T2 invasive bladder cancer

作　　者：李飞[1] 张国飞[2] 邓玮[2] 迪力夏提[2] 马俊杰[2] 闫振[2] 吴越[2] 

机构地区：[1]新疆医科大学研究生院,乌鲁木齐830000 [2]新疆医科大学第六附属医院

出　　处：《中国医师杂志》2015年第3期351-353,共3页Journal of Chinese Physician

基　　金：新疆维吾尔自治区研究生科研创新资助项目（XJGR12014091）;新疆医科大学创新基金资助项目（2013013A）

摘　　要：目的：探讨短周期重复电切术（ Re－TURBT）联合吡柔比星治疗T2期肌层浸润性膀胱肿瘤的疗效及安全性。方法本院2010年10月至2013年12月临床确诊为T2期移行膀胱癌的56例，按患者意愿分为2组，实验组采取短周期重复电切手术治疗，两次电切间隔为4-6周，对照组采取保留膀胱的部分切除术，术后两组患者均给予吡柔比星灌注治疗。结果两组患者共56例均完成治疗。实验组的术中出血量、手术时间明显低于对照组（ P ＜0．05）；术后3、6、12个月膀胱最大容量（MBC）、感知膀胱症状分级量表（ PPBC）高于对照组（ P ＜0．05）；术后3、6个月最大尿流率（Qmax）明显高于对照组（ P ＜0．05），而第12个月两组Qmax差异无统计学意义（ P ＞0．05）。两组不良事件发生率、术后3、6、12个月血管内皮生长因子（ VEGF）阳性率、1年总复发率比较差异无统计学意义（ P ＞0．05）。另实验组膀胱穿孔者1例、被迫转开放者1例，其发生率约为6．7％。结论短周期重复电切术并联合吡柔比星治疗T2期肌层浸润性膀胱肿瘤疗效确切、操作简便、安全性高，可推荐临床使用。Objective To investigate the short-cycle repeated transurethral resection （ Re-TURBT） combined pirarubicin treatment of T2 muscle invasive bladder tumor efficacy and safety.Methods From October 2010 to December 2013, 56 clinically diagnosed cases of bladder cancer were divided into two groups;the experimental group was taken a short-cycle repeat transurethral resection surgery, and the con-trol group taken along open surgery to remove the tumor and its surrounding 2cm bladder tissue, postopera-tive patients were given pirarubicin infusion therapy.Results Each patient completed the trial.For the ex-perimental group, blood loss and operative time was significantly lower than the control group （ P 〈0.05）. For experimental group after 3 months, 6 months, and 12 months, maximum bladder capacity （ MBC） and patient perception of bladder condition （ PPBC） were significantly higher than control group （ P 〈0.05 ） . For experimental group after 3 months and 6 months, maximum urinary flow rate （ Qmax） was significantly higher than control group （ P 〈0.05） , but no significant difference between two groups at 12 months.The incidence of adverse events, vascular endothelial growth factor （ VEGF） , and a total recurrence rate showed no significant difference （ P 〉0.05）.For experimental group, bladder perforation in 1 case, 1 case was forced to open surgery, the incidence rate was about 6.7%.Conclusions The short-cycle repeated trans-urethral resection combined pirarubicin treatment of T2 invasive bladder tumor was simple, effective and se-curity.

关 键 词：膀胱肿瘤/治疗 电外科手术/方法 尿道/外科学 多柔比星/类似物和衍生物/投药和剂量 

分 类 号：R737.14[医药卫生—肿瘤]