论文部分内容阅读
目的探讨丝裂霉素膀胱内灌注预防表浅性膀胱癌术后复发的有效性和安全性。方法 74例表浅性膀胱癌行膀胱部分切除术或行经尿道膀胱肿瘤电切除术,术后1～2周应用丝裂霉素40 mg膀胱灌注,每周1次,连续8周,后改为每月1次,至术后1年。观察治愈率、复发率及不良反应发生率。结果 74例患者均获得随访,时间12～36个月,平均28.6个月。其中54例治愈,有效率73%,20例复发,复发率27%。第1组33例行膀胱部分切除术,有效率72.7%(24/33),复发率27.3%(9/33),不良反应发生率24.2%(8/33);第2组41例行经尿道膀胱肿瘤电切除术(TURBT),有效率73.2%(30/41),复发率26.8%(11/41),不良反应发生率为9.8%(4/41)。不良反应主要为尿路刺激症状。结论应用丝裂霉素膀胱灌注预防表浅性膀胱癌术后复发的疗效满意,用药方便,患者耐受性好,可以降低肿瘤复发率,值得在基层医院推广。
Objective To investigate the effectiveness and safety of intravesical instillation of mitomycin in the prevention of postoperative recurrence of superficial bladder cancer. Methods Totally 74 cases of superficial bladder cancer underwent resection of the bladder or transurethral resection of the bladder tumor. The patients were treated with mitomycin 40 mg intravesical instillation 1 to 2 weeks after operation, once a week for 8 weeks, then changed to Once a month, to 1 year after surgery. Observe the cure rate, relapse rate and incidence of adverse reactions. Results All the 74 patients were followed up for 12-36 months with an average of 28.6 months. 54 cases were cured, the effective rate was 73%, 20 cases of recurrence, the recurrence rate was 27%. The first group of 33 patients underwent partial cystal resection, the effective rate was 72.7% (24/33), the recurrence rate was 27.3% (9/33), the incidence of adverse reactions was 24.2% (8/33); the second group of 41 cases TURBT was effective in 73.2% (30/41) of the patients, the recurrence rate was 26.8% (11/41), and the incidence of adverse reactions was 9.8% (4/41). Adverse reactions mainly urinary tract irritation. Conclusion The application of mitomycin instillation to prevent postoperative recurrence of superficial bladder cancer is satisfactory, the medication is convenient, the patient is well tolerated, which can reduce the recurrence rate of the tumor and is worth popularizing in the primary hospital.