保留膀胱术结合髂内动脉灌注化疗治疗肌层浸润性膀胱癌的效果分析

Effect of bladder preserving surgery combined with internal iliac artery infusion chemotherapy in the treatment of muscle invasive bladder cancer

目的 探讨研究肌层浸润性膀胱癌患者采用膀胱肿瘤切除术后辅助髂内动脉灌注治疗的临床效果.方法 研究选取2012年1月至2015年1月本院不愿接受或不能接受膀胱全切术的肌层浸润性膀胱癌患者84例作为研究对象,全部行尿道膀胱肿瘤电切术（TURBT）,术后将患者分为两组,对照组40例,术后采用全身化疗;实验组44例,术后采用髂内动脉灌注化疗.比较两组患者的膀胱保留率、化疗后不良反应、HIF-1α和VEGF阳性率以及患者的3年生存率.结果 治疗后两组患者的阳性率明显降低,且实验组HIF-1 α和VEGF的阳性率分别为45.5％、36.4％,明显低于对照组的65.0％、52.5％,两组比较差异有统计学意义（P＜0.05）;对照组并发症发生率为45.0％,实验组并发症发生率为25.0％,两组患者差异有统计学意义（P＜0.05）;对照组1年随访膀胱保留率为60.0％,实验组为81.8％,两组差异有统计学意义（P＜0.05）;患者3年生存率实验组为70.5％,对照组为52.5％,差异有统计学意义（P＜0.05）.结论 采用髂内动脉灌注化疗对于肌层浸润性膀胱癌患者效果较好,适合在临床推广.

Objectives To investigate the clinical effect of adjuvant internal iliac artery infusion in patients with muscle invasive bladder cancer after resection of bladder tumor.Methods 84 patients with muscle invasive bladder cancer who refused to accept or not accept bladder resection were selected as the object of study from January 2012 to January 2015 in the hospital.All patients underwent transurethral resection of bladder tumor（TURBT）,who were divided into two groups after operation,the control group （40 cases with systemic chemotherapy）,the experimental group （44 cases with internal iliac artery infusion chemotherapy）.Bladder retention rate,adverse drug reaction,HIF-1 alpha,VEGF positive rate and 3-year survival rate were compared between the two groups.Results The positive rate of the patients in the two groups decreased significantly after treatment and experimental group of HIF-1 alpha and VEGF positive rate was 45.5％,36.4％,significantly lower than control group of 65.0％ and 52.5％,there was statistically significant difference between the two groups（P ＜ 0.05）.In the control group,the incidence of complications was 45.0％,the experimental group complications occurrence rate was 25.0％,the difference between the two groups were obvious （P ＜ 0.05）.1-year follow-up of bladder retention rate of the control group was 60.0％ and the experimental group was 81.8％,the difference was statistically significant（P ＜ 0.05）.3-year survival rate of the experimental group was 70.5％,and the control group was 52.5％,there was statistical significance difference between the two groups （P ＜ 0.05）.Conclusions The effect of internal iliac artery infusion chemotherapy in patients with muscle invasive bladder cancer is better,and it is suitable for clinical promotion.