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目的:应用自主开发研制的BR-TRGⅠ型体腔热灌注治疗仪对膀胱癌患者进行膀胱内温热灌注化疗.探索并建立一种规范化持续循环恒温灌注的膀胱热灌注化疗技术方法。方法:对我院2009年3月～2010年9月收治的10例膀胱癌患者进行膀胱热灌注化疗,每例治疗1～4次,共治疗25例次。术前经尿道插入三腔导尿管至膀胱后固定,夹闭流出管,以其中一腔接灌注管,剩下一腔接流出管。灌注术在手术室或重症监护室内即可完成,术前仅需适当镇静止痛处理,无需特殊麻醉;灌注速度控制在1 50 ml/min,灌注时间为40 min,治疗温度为(45.0±0.2)C,化疗药物选择丝裂霉素C(MMC)60 mg,灌注液总量600 ml;在灌注过程中实时监测患者生命体征。结果:10例患者膀胱热灌注化疗均顺利,调试仪器及放置导尿管、灌注管和引流管平均时间20 min,灌注过程中能够实现持续循环恒温灌注,患者生命体征平稳,无与膀胱热灌注化疗相关的不良反应发生。结论:应用BR-TRGⅠ型体腔热灌注治疗仪对膀胱癌患者进行膀胱热灌注化疗,其技术方法安全可行,能够实现膀胱内持续循环恒温灌注化疗,有着很好的临床应用前景。
OBJECTIVE: To evaluate the bladder intravesical thermochemotherapeutic method by using BR-TRG type I intraluminal hyperthermic perfusion instrument independently developed and developed by the authors. Methods: Ten patients with bladder cancer admitted to our hospital from March 2009 to September 2010 were treated with intravesical heat perfusion chemotherapy, 1 to 4 times per treatment for a total of 25 cases. Preoperative transurethral insertion of three-chamber catheter to the bladder after fixation, the outflow tube clamping, with one of the cavity then perfusion tube, leaving a cavity connected to the outflow tube. Perfusion in the operating room or intensive care unit can be completed preoperative analgesic treatment only appropriate, without special anesthesia; perfusion speed control at 150ml / min, perfusion time was 40 min, the treatment temperature was (45.0 ± 0.2) C, chemotherapeutic drug selection mitomycin C (MMC) 60 mg, total perfusion fluid 600 ml; during the infusion of real-time monitoring of vital signs. Results: All of the 10 patients underwent warm perfusion chemotherapy of bladder. The mean time of instrument and catheter placement, catheterization and drainage tube was 20 min. The perfusion process was able to achieve constant circulation perfusion. The patient’s vital signs were stable without bladder heat perfusion Chemotherapy-related adverse reactions occur. Conclusion: BR-TRG type I intraluminal hyperthermic perfusion therapy is a safe and feasible method for bladder cancer patients with bladder hyperthermic perfusion chemotherapy. It can achieve continuous intravesical infusion of constant temperature perfusion chemotherapy and has good clinical application prospects.