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目的探讨浅表型膀胱肿瘤经尿道气化电切割术加(TURBT)灌注预防术后复发。方法对68例膀胱肿瘤患者采用经尿道气化切割申报切割肿瘤及肿瘤基底部周围0.5~1.0cm正常膀胱黏膜,深达浅肌层,术中A组43例术中用10%葡萄糖冲洗,术后及0.9%生理盐水冲洗膀胱。B组25例术中及术后3d均采用蒸馏水灌注冲洗膀胱,术后第1周A、B组均开始及丝裂霉素MCC40mg灌注膀胱,每周1次,共9次,然后,每4周1次,持续1年。结果68例均顺得完成手术,术中无膀胱穿孔,术后量少,均无需输血,术后无尿路感染,继发性术后膀胱破裂等并发症,所有患者随访1年,A组复发率为11.6%(5/43)。B组为4%(1/25)。结论TURBT加蒸馏水(无菌)连续3d灌注。MCC40mg术后灌注化疗,是浅表性膀胱肿瘤预防术后一种简单有效方法,易于掌握及推广。
Objective To investigate the prevention of postoperative recurrence of superficial bladder tumor transurethral electrovaporization plus (TURBT) perfusion. Methods A total of 68 patients with bladder cancer were treated with transurethral vaporization of the cutaneous tumor and the normal bladder mucosa around 0.5-1.0 cm around the base of the tumor. A group of 43 patients in group A were treated with 10% glucose, After and 0.9% saline flush bladder. In group B, 25 cases were treated with distilled water infusion during the operation and 3 days after operation. Bladder was started in group A and group B at the first week after operation and mitomycin MCC 40 mg was infused into the bladder once a week for 9 times. Then, every 4 1 week, for 1 year. Results All the 68 patients received the surgery without any bladder perforation during the operation. No postoperative blood transfusion, no postoperative urinary tract infection and secondary postoperative rupture of the bladder were observed. All patients were followed up for 1 year. The patients in group A The recurrence rate was 11.6% (5/43). Group B was 4% (1/25). Conclusion TURBT plus distilled water (sterile) continuous 3d infusion. Chemotherapy of MCC40mg after surgery is a simple and effective method for postoperative prevention of superficial bladder tumors and is easy to grasp and popularize.