膀胱癌灌注治疗相关局部不良反应的预防与治疗  

Prevention and treatment of local side effects related to intravesical therapy of bladder cancer

作　　者：陈冠球 刘楠[1] 范晋海[1] CHEN Guanqiu;LIU Nan;FAN Jinhai(Department of Urology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院泌尿外科,陕西西安710061

出　　处：《现代泌尿外科杂志》2021年第4期352-355,共4页Journal of Modern Urology

摘　　要：膀胱灌注治疗可预防肿瘤的复发和进展,但无论是膀胱灌注化疗还是灌注免疫治疗均会产生局部不良反应。其预防措施主要有:选择合适的灌注药物;对灌注治疗实行全程管理;识别危险因素;优化灌注措施;减少卡介苗的灌注剂量和缩短卡介苗膀胱内保留时间。对于灌注化疗药物引起的局部不良反应可口服索利那新或灌注透明质酸钠。对于卡介苗引起的局部不良反应可口服异烟肼、喹诺酮类的抗生素或戊聚糖多硫酸钠,也可膀胱内灌注透明质酸钠或硫酸软骨素。本文综述了膀胱癌灌注治疗相关局部不良反应的预防与治疗,旨在为临床上预防和减轻相关局部不良反应提供参考,改善膀胱癌患者的生活质量,降低治疗中断率并优化肿瘤学结局。Intravesical therapy can prevent recurrence and progression of bladder cancer.However,either intravesical chemotherapy or immunotherapy will produce local side effects.The main preventive measures include:selecting the appropriate intravesical agents;implementing full-course management of intravesical treatment;identifying risk factors;optimizing intravesical measures;reducing the dose of BCG and shortening the retention time of BCG in the bladder.The local side effects caused by chemotherapy drugs can be treated with oral soline or sodium hyaluronate.The side effects caused by BCG can be treated with oral isoniazid or quinolone antibiotics or pentosan polysulfate sodium sulfate,or infusion of sodium hyaluronate or chondroitin sulfate into the bladder.This article reviews the prevention and treatment of local side effects related to bladder cancer intravesical therapy,so as to improve patients quality of life,reduce treatment discontinuation rate and optimize oncological outcomes.

关 键 词：膀胱癌 灌注治疗 尿路刺激征 

分 类 号：R694[医药卫生—泌尿科学]