术中膀胱黏膜下注射盐酸氮芥_术后即刻丝裂霉素灌注化疗.pdf

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1、·246·JOURNALOFBASICANDCLINICALONCOLOGYVol.25No.3Jun.2012术中膀胱黏膜下注射盐酸氮芥、术后即刻丝裂霉素灌注化疗预防膀胱癌复发张二峰，周文定，李国栋，黄枫(平顶山市第二人民医院泌尿外科，河南平顶山467000)［摘要］目的探讨经尿道膀胱肿瘤电切(TUR-Bt)术中膀胱黏膜下注射盐酸氮芥、术后即刻丝裂霉素(MMC)膀胱灌注化疗预防膀胱癌复发的疗效。方法112例行TUR-Bt术的膀胱癌患者随机分为2组，对照组56例:行TUR-Bt术后1周给予MMC常规膀胱灌注化疗;治疗组56例:TUR-Bt术中经尿道行膀胱黏膜下注射盐酸氮芥

2、，术后再即刻行MMC膀胱灌注化疗，术后1周再给予MMC常规膀胱灌注化疗。比较观察2组患者术后3、6、12、18、24个月的复发情况。结果治疗组术后3、6、12、18、24个月的复发率低于对照组，比较差异有统计学意义(P＜0．05)。结论TUR-Bt术中膀胱黏膜下注射盐酸氮芥、术后即刻行MMC膀胱灌注化疗能显著提高膀胱癌治疗效果，减少术后复发，且无明显毒副反应。［关键词］膀胱癌;盐酸氮芥;黏膜下注射;经尿道膀胱肿瘤电切术;丝裂霉素［中图分类号］R737．14;R730．58［文献标识码］A［文章编号］1673－5412(2012)03－0246－03ThePreventio

3、nofRecurrenceofBladderCancerbyIntraoperativeBladderSubmucosalInjectionofHydrochloricAcidNitrogenMustardandPostoperativeImmediateMitomycinInfusionofTransurethralResectionoftheBladderTumorZhangErfeng，ZhouWending，LiGuodong，HuangFeng(DepartmentofUrology，theSecondPeople’sHospitalofPingdingshan

4、，Pingdingshan467000，China)［Abstract］ObjectiveToinvestigatethepreventiveefficacyofintraoperativebladdersubmucosalinjectionofhy-drochloricacidnitrogenmustardandpostoperativeimmediatemitomycin(MMC)infusionfortherecurrenceofblad-dercancerinthetransurethralresectionofthebladdertumor(TUR-Bt)．Me

5、thodsAllthe112patientswithblad-dercancertreatedwithTUR-Btwererandomlydividedintotwogroups:the56casesinthecontrolgroupreceivedtheMMCconventionalbladderinfusion;theother56casesinthetreatmentgroupweretreatedwithintraoperativebladdersubmucosalinjectionofhydrochloricacidnitrogenmustardandposto

6、perativeimmediateMMCinfusion，andreceivedtheMMCconventionalbladderinfusiononeweekaftertheTUR-Bt．Therecurrenceofbladdercancerofthetwogroupsinthe3，6，12，18，24monthsaftertheTUR-Btwereanalyzedcomparatively．ResultsInthe3，6，12，18，24monthsaftertheTUR-Bt，thepostoperativerecurrenceratesofthetreatmen

7、tgroupwerehigherthanthoseofthecontrolgroup，therewasasignificantdifference(P＜0．05)．ConclusionIntheTUR-Bt，intraoperativebladdersubmucosalinjectionofhydrochloricacidnitrogenmustardandpostoperativeimmediateMMCinfusioncansignifi-cantlyimprovethetreatmentefficacyofbladder