膀胱粘膜下浸润注射盐酸氮芥预防膀胱癌术后复发(附106例报告)

Preventing the Recurrence of Bladder Carcinoma by Bladder Submucous Layer Infiltration Injecting Mechlorethamine (report of 106 cases)

目的:评价膀胱粘膜下浸润注射盐酸氮芥预防膀胱癌术后复发的疗效。方法:对106例(90例非浸润性、16例浸润性)膀胱癌患者行膀胱部分切除术,对其中5例浸润性膀胱癌同时切除邻近肿瘤的膀胱周围组织和区域淋巴结,术中用2mg%盐酸氮芥生理盐水溶液100ml～160ml在所剩余膀胱粘膜下全部浸润注射,术后定期用丝裂霉素C(MMC)膀胱灌注。结果:106例随访6个月～13年,平均9年。无肿瘤复发103例,复发3例,总复发率为2.9%。90例非浸润性癌全部无复发。16例浸润性癌,复发3例,复发率18.75%。结论:膀胱粘膜下浸润注射盐酸氮芥预防膀胱癌术后复发疗效好,降低复发率显著,毒副反应少,临床应用安全可靠。

Objective: To evaluate the efficacy of submucous layer infiltration injecting mechlorethamine to control the recurrence of bladder carcinoma. Methods: 106 cases of bladder carcinoma (90 cases of non-infiltrated, 16 cases of infiltrated) were treated with partial cystectomy. chlormethine was injected to all the residual submucous during operation and irrigated MMC regularly postoperation. Results: The total rate of recurrence was 2.9%. None of 90 cases of non-infiltrated bladder carcinoma recured in five years, The rate of recurrence of 16 cases of infiltrated bladder carcinoma was 18.75%. Conclusions: The effect of submucous injecting chlormethine for controlling postoperative recurrence of bladder carcinoma is obvious and the technique is simpler, easier with minimal complications.