膀胱内灌注化疗药物的方法改进及效果观察

Observation on the improvement and effect of intravesical chemotherapy

目的探讨膀胱肿瘤患者行经尿道膀胱肿瘤电切术(transurethral resection of bladder,TURBT)术后膀胱内灌注化疗药物的个体细化灌注方法及护理效果。方法 112例TURBT后行膀胱内灌注化疗药物的非浸润性膀胱肿瘤患者,按治疗时间段先后分为对照组(49例)和观察组(63例),对照组采取常规膀胱内化疗药物灌注;观察组根据患者的个人情况采取个性化的膀胱内化疗药物灌注方法,包括灌注前评估患者情况,选择合适的尿管,灌注药物加温,灌注药物的个性化排出方式及拔除尿管的时间等。观察两组患者按规定完成全程灌注的治疗依从性、排尿不适症状等情况。结果观察组患者膀胱痉挛性疼痛程度评分明显低于对照组,生活质量指数评分及按规定完成全程膀胱灌注治疗的依从率明显高于对照组。结论 TURBT术后膀胱内灌注化疗药物应根据患者的具体情况采取个性化的灌注方法,可减少患者排尿不适症状,提高患者治疗的依从性及生存质量,达到膀胱肿瘤治疗的目的。

Objective To discuss the bladder irrigation methods and nursing effects of bladder cancer patients who treated by transurethral resection of bladder tumor（TURBT）. Methods 112 patients with non-muscle invasive bladder cancer were treated by transurethral resection of tumor, combined with bladder irrigation treatment in our hospital urology department from January 2009 to December 2011. Among those 112 patients, from January 2009 to September 2010, 49 patients were enrolled in control group, which applied common practice of bladder irrigation approach. From Octo- ber 2010 to December 2011, 63 patients were enrolled as observation group, which applied individual bladder irrigation approach according to patient＇s personal circumstance, including pre-bladder irri- gation assessment, appropriate folly catheter selection, infusion drug hitting, select the means of e- liminating infusion drug and the proper time to remove folly catheter. Last, to observe patients com- pliance, comfort level of two groups after full irrigation treatment. Results The scores that evalu- ate the patients with spastic bladder pain in observation group were significantly lower than control group. On the other side, the scores that evaluate the quality of life index and the patients compli- ance and comfort level after full infusion treatment in observation group were higher than control group. Conclusions TURBT combined with bladder irrigation should be taken and applied individ- ual approach according to patient＇s personal circumstance which reduces voiding symptoms, im- proves patient compliance and prevents the tumor recurrence for the purpose of improving the quality of life in patient.