刘天冬  赵培湘

[摘要] 目的 研究吡柔比星（THP）膀胱灌注对预防膀胱癌术后发作的临床疗效。 方法 选取2012年4月～2013年11月期间我院收治的46例膀胱癌患者作为研究对象，所有患者在经尿道膀胱肿瘤电切术后随机分为A、B两组。A、B两组分别为THP和丝裂霉素C（MMC）膀胱灌注，手术后第1周开始，每周1次，共8次，以后每2周1次，共8次，再以后每月1次，共2年。 结果 86例患者均随访2年以上，A组患者复发率0，B组为21.05%，两者具有统计学差异（P＜0.05）；且A组发生各种不良反应的患者均少于B组，局部不良反应中发生尿频的患者差异显著（P＜0.05），血尿、膀胱疼痛和膀胱炎差异不显著（P＞0.05）；全身不良反应差异显著（P＜0.05）。 结论 THP膀胱灌注对预防膀胱癌术后发作具有良好的临床效果，且无严重不良反应，值得在临床上应用。

[关键词] 膀胱癌；THP；MMC；膀胱灌注

[中图分类号] R737.14   [文献标识码] B   [文章编号] 2095-0616（2014）08-75-03

Intravesical instillation of pirarubicin bladder cancer clinical study on the prevention of postoperative seizure

LIU Tiandong  ZHAO Peixiang

Department of Urology,Dandong Central Hospital of Liaoning Province, Dandong 118002,China

[Abstract] Objective To study the pirarubicin(THP) on the clinical effect of intravesical instillation to prevent bladder cancer postoperative seizure. Methods 46 cases of bladder cancer in our hospital from April 2012 to November 2013 were selected as the object of study, all patients in transurethral resection of bladder tumor were randomly divided into A, B two groups. A, B two groups were respectively THP and mitomycin C(MMC) in bladder perfusion, operation after the first week, 1 times a week for a total of 8 times,later every two weeks a total of 8 times,1 times a month to a total of two years later. Results 46 patients were followed up for more than two years, the A group patients relapse rate was 0, B group 21.05%, both had statistical difference(P＜0.05); and the adverse reactions in A group were less than that in B group, the differences in patients with urinary frequency of local adverse were significant(P＜0.05), but hematuria, bladder pain and cystitis were not significant(P＞0.05); systemic adverse reactions were significantly different (P＜0.05). Conclusion Intravesical instillation of THP has good clinical effect on prevention of bladder cancer postoperative seizure, and no serious adverse reactions, is worthy of clinical application.

[Key words] Bladder cancer; THP; MMC; Bladder perfusion

膀胱癌是泌尿系统中常见的肿瘤，以移行上皮细胞癌最为多见，临床上以外科治疗为主，手术较为简单，治疗彻底，但术后肿瘤复发率较高（50%～70%）[1]。膀胱灌注是预防移行上皮细胞癌术后复发的有效方法。本次研究中，我们选取2012年4月～2013年11月期间我院收治的46例膀胱癌患者作为研究对象，研究吡柔比星膀胱灌注对预防膀胱癌的术后发作的临床效果，现将结果报道如下。

1 资料与方法

1.1 一般资料

选取2012年4月～2013年11月期间我院收治的46膀胱癌患者作为研究对象，其中男39例，女7例，年龄52～71岁，平均（61.4±7.1）岁。所有患者术后病理证实为膀胱移行上皮细胞癌，其中T1 28例，T2 18例。将46例患者随机分为A、B组，两组患者性别、年龄、手术病理分期差异无统计学意义。……