PA-MSHA和吡柔比星膀胱灌注治疗的对比分析  

Comparative analysis between PA-MSHA and Pirarubicin in treatment of bladder instillation

作　　者：张中沛 刘清源 王灵点 段小雨 刘闯 孙春山 丁德刚 ZHANG Zhong- pei;LIU Qing -yuan;WANG Ling -dian;DUAN Xiao- yu;LIU Chuang;SUN Chun- shah;DING De- gang(Department of Urology,Peopge ＇ s Hospitag of Zhengzhou University,Henan Provicial People＇s Hospital,Zhengzhou 450003,Chin)

机构地区：[1]郑州大学人民医院河南省人民医院泌尿外科,450003

出　　处：《现代泌尿生殖肿瘤杂志》2018年第2期85-88,共4页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：河南省基础与前沿技术研究项目(152300410149)

摘　　要：目的探讨非肌层浸润性膀胱尿路上皮癌患者行经尿道膀胱肿瘤电切术(TURBT)后铜绿假单胞菌-甘露糖敏感血凝菌毛株(pseudomonas aeruginosa-mannose sensitive hemagglutinin,PA-MSHA)和吡柔比星膀胱灌注治疗的有效性及安全性。方法选取行TURBT的非肌层浸润性膀胱尿路上皮癌患者91例,根据膀胱灌注药物的不同分为实验组(41例)和对照组(50例),实验组患者术后24h内膀胱灌注PA-MSHA,对照组患者术后24h内膀胱灌注吡柔比星,随访患者规律灌注后的不良反应及肿瘤复发情况。结果实验组发生急性膀胱炎3例,血尿3例,发热2例,胃肠道反应1例,不良反应发生率为21.95%(9/41);复发例数为10例,术后6个月复发3例,术后12个月复发5例,术后24个月复发2例,总复发率为24.39%(10/41)。对照组发生急性膀胱炎8例,血尿5例,发热5例,胃肠道反应3例,不良反应发生率为42.00%(21/50);复发例数为11例,术后6个月复发6例,术后12个月复发4例,术后24个月复发1例,总复发率为22.00%(11/50)。结论 PA-MSHA和吡柔比星两种灌注药物对于预防非肌层浸润性膀胱癌患者TURBT术后复发的疗效差异无统计学意义,但两者不良反应的发生率存在差异,PA-MSHA的不良反应发生率低于吡柔比星。Objective To compare the safety and efficacy between pseudomonas aeruginosamannose sensitive hemagglutinin（PA-MSHA）and pirarubicin for intravesical instillation after transurethral resection of bladder tumor（TURBT）in patients with non-muscle-invasive bladder transitional epithelial carcinoma. Methods Ninety-one cases of non-muscular infiltrating bladder transitional epithelial cancer who underwent TURBT were enrolled.TURBT after excluding related surgical contraindications,then in 24 hours the experimental group,41 cases received intravesical infusion of PA-MSHA,while the control group,50 cases received intravesical instillation of pirarubicin.Patients were followed up regularly,and adverse reactions and recurrence of perfusion were observed. Results In the experimental group,3 cases of bladder irritation,3 cases of hematuria,2 cases of fever and 1 case of gastrointestinal reaction were found.The incidence of adverse reactions was 21.95%（9/41）.The number of recurrent cases was 10,3 cases recurred 6 months after operation,5 cases recurred 12 months after operation,and 2 cases recurred 24 months after operation.The total recurrence rate was 24.39%（10/41）.In the control group,8 cases of bladder irritation,5 cases of hematuria,fever in 5 cases,3 cases of gastrointestinal reactions were found.The incidence of adverse reactions was 42.00%（21/50）.The number of recurrent cases was 11,6 cases recurred in 6 months,4 cases recurred in 12 months and 1 case recurred in 24 months,the total recurrence rate was 22.00%（11/50）. Conclusions There was no statistically significant difference in the efficacy between PA-MSHA and pirarubicin in preventing the recurrence of non-muscle-invasive bladder cancer after TURBT.However,there was significant difference in the incidence of adverse reactions between the two,and the incidence of adverse events in PA-MSHA was lower than that of pirarubicin.

关 键 词：膀胱肿瘤 铜绿假单胞菌-甘露糖敏感血凝菌毛株 吡柔比星 经尿道膀胱肿瘤电切术 膀胱灌注 

分 类 号：R737.14[医药卫生—肿瘤]