浅表膀胱癌经尿道电切术后早期膀胱灌注与常规膀胱灌注的疗效对比观察

Efficacy comparison of immediate and conventional instillation of chemotherapy after transurethral resection for superficial bladder cancer

目的:比较浅表膀胱癌经尿道电切术后行早期膀胱灌注与常规膀胱灌注的临床疗效。方法:选取164例浅表膀胱癌患者,随机分为早期灌注组(75例)和常规灌注组(89例),分别于术后24h内行膀胱灌注与术后7 d行膀胱灌注,随访比较两组患者术后并发症及复发情况。结果:早期灌注组复发率为12.0%,复发时间平均为术后15个月;常规灌注组复发率为34.83%,复发时间平均为术后9个月。两组比较,早期灌注组复发率低于常规灌注组(P<0.05),复发时间推迟(P<0.05)。膀胱灌注后少数患者出现膀胱炎,两组比较无显著性差异。两组患者白细胞计数和肝肾功能均未见明显异常。结论:早期行膀胱灌注较常规膀胱灌注能明显降低膀胱癌术后复发率,推迟复发时间;两种灌注方法对患者术后膀胱炎等并发症的影响没有差异。表明早期行膀胱灌注是一种预防浅表膀胱癌术后复发及并发症的安全有效疗法。

Objective：To compare the efficacy of immediate and conventional instillation of chemotherapy after transurethral resection for superficial bladder cancer（SBC）.Methods： Total of 164 patients with SBC who have been operated were randomly divided into two groups,the first group（75 patients） were treated with chemotherapy by irrigation of the bladder in 24h after the operation and the second group（89 patients） were treated in an identical fashion after the operation for 7d.Then,time to first recurrence,recurrence rate and complications of SBC were observed.All patients were followed up for at least two years.Results： Nine of 75 patients（12.0 %） had recurrence of SBC at 15 months after the operation in the immediate instillation group,and 31 of 89 patients（34.83 %） had recurrence of SBC at 9 months receiving conventional postoperative instillation of chemotherapy.Compared with conventional instillation group,immediate postoperative instillation of chemotherapy significantly decreased the recurrence of SBC（P0.05） and delayed time to first recurrence（P0.05）.Incidence rate of drug-induced cystitis in two groups were low and no statistical difference was observed between two groups.However,white blood cell count,liver and kidney functions had not been affected by immediate and co、nventional instillation of chemotherapy.Conclusion： The immediate instillation of chemotherapy after TUR is feasible and safe in patients with superficial bladder cancer