术中膀胱黏膜下注射盐酸氮芥、术后即刻丝裂霉素灌注化疗预防膀胱癌复发

The Prevention of Recurrence of Bladder Cancer by Intraoperative Bladder Submucosal Injection of Hydrochloric Acid Nitrogen Mustard and Postoperative Immediate Mitomycin Infusion of Transurethral Resection of the Bladder Tumor

目的探讨经尿道膀胱肿瘤电切(TUR-Bt)术中膀胱黏膜下注射盐酸氮芥、术后即刻丝裂霉素(MMC)膀胱灌注化疗预防膀胱癌复发的疗效。方法 112例行TUR-Bt术的膀胱癌患者随机分为2组,对照组56例:行TUR-Bt术后1周给予MMC常规膀胱灌注化疗;治疗组56例:TUR-Bt术中经尿道行膀胱黏膜下注射盐酸氮芥,术后再即刻行MMC膀胱灌注化疗,术后1周再给予MMC常规膀胱灌注化疗。比较观察2组患者术后3、6、12、18、24个月的复发情况。结果治疗组术后3、6、12、18、24个月的复发率低于对照组,比较差异有统计学意义(P<0.05)。结论 TUR-Bt术中膀胱黏膜下注射盐酸氮芥、术后即刻行MMC膀胱灌注化疗能显著提高膀胱癌治疗效果,减少术后复发,且无明显毒副反应。

Objective To investigate the preventive efficacy of intraoperative bladder submucosal injection of hydrochloric acid nitrogen mustard and postoperative immediate mitomycin （MMC） infusion for the recurrence of bladder cancer in the transurethral resection of the bladder tumor （TUR-Bt）. Methods All the 112 patients with blad- der cancer treated with TUR-Bt were randomly divided into two groups： the 56 cases in the control group received the MMC conventional bladder infusion; the other 56 cases in the treatment group were treated with intraoperative bladder submucosal injection of hydrochloric acid nitrogen mustard and postoperative immediate MMC infusion,and received the MMC conventional bladder infusion one week after the TUR-Bt. The recurrence of bladder cancer of the two groups in the 3,6,12,18,24 months after the TUR-Bt were analyzed comparatively. Results In the 3,6,12, 18,24 months after the TUR-Bt,the postoperative recurrence rates of the treatment group were higher than those of the control group,there was a significant difference （ P 〈 0.05）. Conclusion In the TUR-Bt,intraoperative bladder submucosal injection of hydrochloric acid nitrogen mustard and postoperative immediate MMC iutusion can significantly improve the treatment efficacy of bladder cancer, reduce the recurrence,and the toxicities are tolerated.