膀胱热灌注预防非浸润性膀胱癌术后疗效观察及护理

The efficacy and nursing Measure of Bladder Hyperthermal Perfusion for the Prevention of Postoperative recurrence for Non- invasive Bladder Cancer

目的 探讨丝裂霉素C（Mitomycin C,MMC）热灌注化疗对非浸润性膀胱癌（Non-invasive bladder cancer,NIBC）术后复发的预防效果,并采取合理的护理措施。方法 选择2010年6月-2011年12月在本院接受经尿道膀胱肿瘤电切术（TUR-Bt）的68例NIBC患者,术后膀胱灌注预防复发,按照灌注方式不同随机分为观察组和对照组各34例,观察组采用术后3d行MMC热灌注,对照组术后24h行MMC传统灌注,随访获得患者的复发情况及不良反应发生情况。结果 所有患者均获得随访,时间14-24个月,观察组4例复发,复发率为11.8%,复发时间（18.5±5.4）个月,对照组11例复发,复发率为32.4%,复发时间（13.9±4.8）个月;观察组不良反应明显少于对照组。上述比较项差异均具有统计学意义（P〈0.05）。结论 MMC热灌注化疗预防NIBC术后复发的效果显著,且安全可靠,值得临床上进一步推广;可以通过加强健康教育、心理干预、全程针对性护理措施来减少不良反应的发生。

Objective To observe and explore the efficacy of Bladder Hyperthennal Perfusion with Mitomycin C （MMC） for the prevention of postoperative recurrence for non - invasive bladder cancer （NIBC） , and put forward reasonable nursing measures. Methods 68 cases with NIBC underwent transurethral resection of bladder tumor （ TUR - Bt） from June 2010 to December 2011 in our hospital were selected, bladder perfused to prevent the recurrent of NIBC after surgery, patients were divided into observation group and control group accorded to different bladder perfusion methods, observation group was hyperthermal perfused with MMC 3d after surgery, and control group traditional perfused with MMC 24h after surgery ,patients were followed -up,recurrence and adverse reactions in two groups were recorded. Results All patients were followed up for 14 -24 months,4 cases recurred in the observation group,recurrence rate was 11.8% ,the recurrence time was （18.5 ± 5.4） months, 11 cases recurred in the control group,the recurrence rate was 32.4% ,the recurrence time was （13.9 ±4.8 ） months;adverse reactions in the observation group was significantly less than in the control group. The differences of above items were statistically significant（ P 〈 0. 05 ）. Conclusion MMC Hyperthermal Perfusion chemotherapy has a significant effect for NIBC recurrence prevention, as well as safety and reliable, thus worthy of further promotion in clinical; By strengthening health education, psychological intervention, and the entire nursing measures to reduce the incidence of adverse reactions.