CAJ | 학술논문

目的探讨比较经尿道膀胱肿瘤电切(TUR-Bt)术中膀胱黏膜下注射盐酸氮芥与术后即刻灌注吡柔比星(THP)化疗预防非肌层浸润性膀胱癌复发的疗效.方法将64例行TUR-Bt术的膀胱癌患者随机分为A、B两组,A组34例术中膀胱黏膜下注射盐酸氮芥；B组30例于手术后采用吡柔比星膀胱灌注.观察各组肿瘤复发情况、毒副反应.结果 A组平均随访37.1个月,4例复发,复发率11.8％；B组平均随访36.2个月,7例复发,复发率23.3％,两组之间差异有统计学意义(P＜0.05).所有患者未见明显的全身性药物反应.结论术中黏膜下注射盐酸氮芥和术后早期膀胱灌注吡柔比星显著降低非肌层浸润性膀胱癌术后复发率,其中术中黏膜下注射优于术后早期灌注,两组之间副作用无明显差异.
목적 탐토비교경뇨도방광종류전절(TUR-Bt)술중방광점막하주사염산담개여술후즉각관주필유비성(THP)화료예방비기층침윤성방광암복발적료효.방법 장64례행TUR-Bt술적방광암환자수궤분위A、B량조,A조34례술중방광점막하주사염산담개；B조30례우수술후채용필유비성방광관주.관찰각조종류복발정황、독부반응.결과 A조평균수방37.1개월,4례복발,복발솔11.8％；B조평균수방36.2개월,7례복발,복발솔23.3％,량조지간차이유통계학의의(P＜0.05).소유환자미견명현적전신성약물반응.결론 술중점막하주사염산담개화술후조기방광관주필유비성현저강저비기층침윤성방광암술후복발솔,기중술중점막하주사우우술후조기관주,량조지간부작용무명현차이.
Objectives To investigate the preventive efficacy of intraoperative bladder submucosal injection of hydrochloric acid nitrogen mustard and postoperative immediate instillation of pirurubicin for the recurrence of bladder cancer in the transurethral resection of the bladder tumor (TUR-Bt).Methods All the 42 patients with bladder cancer treated with TUR-Bt were randomly divided into two groups,group A and group B.Hydrochloric acid nitrogen was injected submucously during operation to patients in group A; Patients in group B received immediate instillation of pirurubicin.The recurrence rates and side effects after treatment were evaluated.Results The recurrence rates of group A (mean follow up of 37.1 months) was 15％ ; The recurrence rates of group B (mean follow up of 36.2 months) was 31.8％,the difference was statistically significant (P ＜0.05).No systemic side effect had been observed in all patients.Conclusions Intraoperative bladder submucosal injection of hydrochloric acid nitrogen mustard and postoperative immediate instillation of pirurubicin can both effectively reduce the recurrence rate o f superficial bladder tumor,but the former is more effective.No significant difference was found in side effects between the two groups.