膀胱粘膜下注射丝裂霉素C预防膀胱癌术后复发的疗效观察

Effects of submucosal injection of mitomycin C on the prevention of postoperative recurrence of bladder cancer

目的：观察膀胱粘膜下注射丝裂霉素 Ｃ预防膀胱癌术后复发的临床疗效。方法：８５ 例膀胱癌患者随机分为两组：（１）粘膜下注药组４３ 例，在肿瘤切除后术中应用丝裂霉素 Ｃ６～８ ｍ ｇ 加生理盐水４０～６０ ｍ Ｌ行膀胱粘膜下注射。（２）对照组４２ 例，术后应用丝裂霉素 Ｃ２０ ｍ ｇ 加生理盐水４０ ｍ Ｌ定期膀胱内灌注。观察两组肿瘤复发情况。结果：经随访１２～６６ 个月，平均３８ 个月，粘膜下注药组肿瘤复发率为９．３％ ，膀胱内灌注组为３０．９％ ，两组比较，差异有显著性（ Ｐ＜０．０５）。粘膜下注射丝裂霉素 Ｃ未见明显的副作用。结论：膀胱粘膜下注射丝裂霉素 Ｃ能更有效地预防膀胱癌的术后复发，具有操作简单，安全，副作用少，费用低等优点。

Objective:To observe the clinical effect of submucosal injection of mitomycin C on the prevention of recurrence of bladder cancer.Methods:85 patients with bladder cancer were divided randomly into two groups:(1)43 cases were treated with mitomycin C at doses of 6 8mg in 40～60 mL normal saline in submucosal injection during operation.(2)42 cases were treated with mitomycin C at doses of 20 mg in 40 mL normal saline in intravesical instillation postoperatively as control group. Results:The patients were followed up ranged from 12 to 66 months (mean 38 months),the recurrence rate of tumor were 9.3% in submucosal injection group and 30.9% in intravesical instillation group ( P <0.05).Conclusion:The result showed that submucosal injection of mitomycin C appear to be an effective prophylaxis against recurrence of bladder cancer.