即刻灌注吉西他滨对非肌层浸润性膀胱癌术后预后的影响

Effect of Immediate Infusion Gemcitabine on Postoperative Prognosis in Patients with Non-muscular Layer Invasive Bladder Cancer

目的分析即刻灌注与术后1周灌注吉西他滨对非肌层浸润性膀胱癌(NMIBC)术后预后的影响。方法选取2014年3月—2016年4月收治的经病理检查确诊并行尿道膀胱肿瘤电切术(TURBT)的NMIBC 124例,按治疗方式分为观察组与对照组,每组62例。观察组即刻膀胱灌注吉西他滨,对照组术后1周膀胱灌注吉西他滨。观察2组术后复发率和不良反应发生情况。结果治疗后,观察组术后1、2年复发率低于对照组(P <0. 05)。观察组血尿发生率高于对照组(P <0. 05)。观察组治疗后患者满意度高于对照组(P <0. 05)。结论 NMIBC患者TURBT术后即刻行吉西他滨膀胱灌注治疗效果优于术后1周灌注治疗,但对于术中出现膀胱穿孔等严重并发症者,应避免术后即刻灌注治疗。

Objective To investigate effects of postoperatively immediate infusion and perfusion Gemcitabine in 1 week after operation on postoperative prognosis in patients with non-muscle layer invasive bladder cancer （NMIBC）. Methods A total of 124 NMIBC patients undergoing transurethral resection of bladder tumor （TURBT） admitted during March 2014 and April 2016, who were confirmed by pathological examination, were divided into observation group and control group （u = 62 for each group） according to different treatment methods. Observation group was treated with infusion Gemcitabine immediately by irrigation of bladder, while control group was treated with perfusion Gemcitabine in 1 week after operation. Postoperative recurrence rate and incidence rate of adverse reactions were observed in two groups. Results After treatment, recurrence rates in 1 and 2 years after operation in observation group were significantly lower than those in control group （P 〈 0.05）. Incidence rate of hematuria in observation group was significantly higher than that in control group （P 〈 0.05 ）. The postoperative satisfaction rate in observation group was significantly higher than that in control group （P 〈 0.05）. Conclusion Effectiveness of postoperatively immediate infusion Gemcitabine in treat- ment of NMIBC patients undergoing TURBT is better than that by peffusion Gemcitabine in 1 week after operation, how- ever postoperatively immediate infusion Gemcitabine should be avoided for patients with serious complications during oper- ation such as vesieal perforation.