不同溶剂配制吡柔比星在经尿道膀胱肿瘤电切术后膀胱灌注的疗效观察

Clinical observation of intravesical chemotherapy with pirarubicin reconstituted with different solvents following TUR Bt

目的评价生理盐水和注射用水配制吡柔比星在经尿道膀胱肿瘤电切(TURBt)术后膀胱灌注的疗效和副反应。方法将TURBt术后30例膀胱癌患者随机分为两组,分别用生理盐水和注射用水配制吡柔比星进行膀胱灌注,观察疗效并随访。结果两组随访12～18个月,均无肿瘤复发,术后3,6个月查肝肾功能和血常规均正常。生理盐水组有明显膀胱刺激症12例,术后3个月膀胱镜检查有溃疡形成6例,被迫停止灌药4例。注射用水组有明显膀胱刺激症5例,术后3个月膀胱镜检查有溃疡形成2例,被迫停止灌药1例。结论生理盐水和注射用水配制吡柔比星在TURBt术后膀胱灌注均有较好的预防膀胱癌复发的疗效,但生理盐水组有明显膀胱刺激症,并可引起膀胱溃疡。

Objective To assess the efficacy and side effect of intravesical chemotherapy with pirarubicin reconstituted with 0.9% sodium chloride injection or water injection following TUR Bt.Methods Following TUR Bt, 30 patients were randomized into two intravesical treatment groups:(1)Pirarubicin reconstituted with 0.9% sodium chloride injection( n =15);(2)Pirarubicin reconstituted with water injection( n =15). Response was assessed during the follow up.Results During the follow up for 12 to 18 months, no recurrence was detected. The blood routine and the functions of kidney and liver were normal in 3 and 6 months after TUR Bt in all patients. In the water injection group, obvious bladder irritative symptom occurred in 12 cases and bladder ulcer detected by cytoscopy was apparent in 6 cases after 3 month. Furthermore, the intravesical chemotherapy was forced to be halted in 4 of 15 cases. In the other group,obvious bladder irritative symptom and bladder ulcer occurred in 5 and 2 cases respectively.One patient was forced to halt this treatment.Conclusions The intravesical chemotherapy with pirarubicin reconstituted with 0.9% sodium chloride injection and water injection can prevent the recurrence of bladder tumor effectively.Compared with pirarubicin reconstituted with water injection,the pirarubicin reconstituted with 0.9% sodium chloride injection seemed to be apt to cause bladder irritative symptom and bladder ulcer.