二次经尿道电切加术中黏膜下注射吡柔比星治疗表浅性膀胱肿瘤效果分析

Curative analysis of secondary transurethral resection combined with sub-mucosal injection of pirarubicin in the operation in treatment of superficial bladder tumor

目的 对比分析二次经尿道电切（ReTUR）加术中黏膜下注射吡柔比星并与单次电切术（TURBt）后即刻灌注吡柔比星治疗表浅性膀胱肿瘤的效果.方法 选择2012年3月～2013年3月汕头大学医学院第一附属医院收治的首次接受TURBt后即刻灌注吡柔比星的浅性膀胱肿瘤患者64例,分为对照组（32例）和观察组（32例）.观察组于4～6周接受ReTUR加术中黏膜下注射吡柔比星.随访12个月,观察分析对相关不良反应发生情况,以及肿瘤复发率.结果 两组患者手术均获得成功,膀胱肿瘤切除率100.00％.随访期间,两组均有3例出现尿频、尿急、尿痛.对照组复发15例,复发率为46.88％;观察组复发7例,复发率为21.88％,两组差异有统计学意义（P＜0.05）.结论 二次经尿道电切加术中黏膜下注射吡柔比星治疗表浅性膀胱肿瘤具有良好的预防复发效果和安全性,值得临床推广和应用.

Objective To compare and analyze the curative effect of secondary transurethral resection plus sub-mucosal injection of pirarubicin in the operation（Re TUR） and instillation of pirarubicin immediately after single transurethral resection（TURBt）. Methods From March 2012 to March 2013, in the First Hospital Affiliated to Medical College of Shantou University, 64 patients with superficial bladder tumor and first received TURBt and were immediately injected with instillation were selected and divided into the observation group（32 cases） and the control group（32 cases）. The patients in the the observation group received Re TUR combined with sub-mucosal injection of pirarubicin during 4-6weeks. During the 12-month follow-up, the related adverse reaction and the tumor recurrence rate were observed and analyzed. Results The operations on the patients in the two groups were successful and the resection rate of bladder tumor was 100.00%. During follow-up period, 3 cases in each group suffered frequent micturition, urgency and dysuria.15 cases in the control group recurred, and the recurrence rate was 46.88%; while 7 cases in the observation group recurred, and the recurrence rate was 21.88%, the difference was statistically significant（P 〈0.05）. Conclusion The treatment of the secondary transurethral resection combined with sub-mucosal injection of pirarubicin in the operation in treatment of superficial bladder tumor has a relapse prevention effect and good safety, which is worth the clinical promotion and application.