CAJ | 학술논문

目的：探讨表柔比星与丝裂霉素膀胱灌注预防浅表性膀胱癌术后复发的临床疗效。方法选择择期行经尿道电切术的浅表性膀胱癌患者132例，随机分为A，B，C组，各44例，A组采用表柔比星单次灌注，B组采用表柔比星多次灌注，C组采用丝裂霉素多次灌注。结果治疗后，A组和B组CD4＋与CD4＋／CD8＋表达水平均明显升高，B组CD8＋表达水平明显降低，C组CD4＋水平明显升高（P＜0．05），且A 组和 B 组 CD4＋与 CD4＋／CD8＋表达水平明显高于 C 组（P ＜0．05）；成本-效果比值 A 组为2524．62，B 组为3465．64，C 组为7136．71，B组和C组均高于A组（P＜0．05）；A组不良反应发生率为29．55％，B组为34．09％，C组为68．18％，A组低于B组，B组低于C组（P＜0．05）；随访1年后，A组复发率为13．64％，B组为11．36％，均明显低于C组的18．18％（P＜0．05）。结论对浅表性膀胱癌术后患者采用表柔比星灌注，能降低复发率，提高患者抗肿瘤免疫水平，安全性佳，对于经济条件允许的患者，可作为首选灌注药物。
목적：탐토표유비성여사렬매소방광관주예방천표성방광암술후복발적림상료효。방법선택택기행경뇨도전절술적천표성방광암환자132례，수궤분위A，B，C조，각44례，A조채용표유비성단차관주，B조채용표유비성다차관주，C조채용사렬매소다차관주。결과치료후，A조화B조CD4＋여CD4＋／CD8＋표체수평균명현승고，B조CD8＋표체수평명현강저，C조CD4＋수평명현승고（P＜0．05），차A 조화 B 조 CD4＋여 CD4＋／CD8＋표체수평명현고우 C 조（P ＜0．05）；성본-효과비치 A 조위2524．62，B 조위3465．64，C 조위7136．71，B조화C조균고우A조（P＜0．05）；A조불량반응발생솔위29．55％，B조위34．09％，C조위68．18％，A조저우B조，B조저우C조（P＜0．05）；수방1년후，A조복발솔위13．64％，B조위11．36％，균명현저우C조적18．18％（P＜0．05）。결론대천표성방광암술후환자채용표유비성관주，능강저복발솔，제고환자항종류면역수평，안전성가，대우경제조건윤허적환자，가작위수선관주약물。
Objective To explore the efficacy of epirubicin and mitomycin in bladder perfusion for the prevention of postoperative recur-rence of superficial bladder cancer.Methods 132 cases of superficial bladder cancer patients with transurethral plasmakentic vaporiza-tion of electricity cut method were randomly divided into group A,group B and group C,44 cases in each group.Group A used epiru-bicin single perfusion,group B used epirubicin multiple perfusion,group C used mitomycin multiple perfusion.Results After treatment, CD4 +,CD4 +/CD8+ expression levels of group A and group B increased,CD8 + expression level of group B decreased,CD4 + expression levels of group C increased(P <0.05).Comparison between groups,CD4+,CD4+/CD8+ expression level of group A and group B were higher than that of group C(P <0.05).The cost-effectiveness ratio of group A was 2 524.62,group B was 3 465.64,and group C was 7 136.71,group B and group C were higher than group A(P <0.05).The adverse reactions rate of group A was 29.55%,group B was 34.09%,group C was 68.18%,group A was lower than that of group B,and group B was lower than group C(P <0.05). After follow-up of 1 year,the recurrence rate of group A was 13.64%,group B was 11.36%,which were both lower than 18.18%of group C(P <0.05).Conclusion Using epirubicin single perfusion for patients with superficial bladder cancer after operation can lower the recurrence rate,improve the level of antitumor immune,and has less adverse reaction.At the same time,the treatment has a large cost advantage and can be used as the preferred treatment.