老年非肌层浸润性膀胱癌经尿道电切术后吉西他滨膀胱灌注的疗效

Clinical observation of gemcitabine irrigation after transurethral resection of non-muscle invasive bladder tumor in gerontal patients

目的探讨经尿道电切术后联合吉西他滨膀胱灌注治疗非肌层浸润性膀胱癌患者临床疗效、不良反应及对生存质量的影响。方法选取作者单位2013年2月至2016年2月收治的102例膀胱癌患者,年龄均> 60岁,且术后病理类型均为非肌层浸润性膀胱癌,随机分为观察组(n=50)和对照组(n=52)。两组患者均行经尿道电切术,术后观察组采用吉西他滨膀胱灌注,对照组采用吡柔比星膀胱灌注。观察比较两组术后复发情况、不良反应发生情况及患者生存质量。结果观察组1年复发率为6.0%,2年复发率10.0%,2年总复发率16.0%,均明显低于对照组的11.5%、25.0%和36.5%。治疗后两组患者生存质量均显著提高,差异具有统计学意义(P<0.001);且观察组得分明显高于对照组(P<0.001)。观察组发生尿频、尿痛及血尿等不良反应共18例,不良反应发生率36.0%,显著低于对照组的57.7%,差异有统计学意义(P<0.001)。结论老年非肌层浸润性膀胱肿瘤患者采用经尿道电切术联合吉西他滨灌注治疗可有效减少术后复发率及不良反应发生率,提高患者生存质量。

Objective To investigate the effect of transurethral resection combined with gemcitabine bladder perfusion in the treatment of non-muscular invasive bladder cancer.Methods A total of 102 non-muscleinvasive bladder cancer patients aged over 60 from February 2013 to February 2016 were involved and divided into experimental group(n=50)and control group(n=52)randomly.After treated with transurethral resection,the experimental group was given gemcitabine bladder perfusion and the control group pirarubicin bladder perfusion.Postoperative recurrence,adverse reactions and the quality of life of patients were observed and compared between two groups.Results Recurrence rate of the experimental group was 6.0% after one year and 10.0% after two years and the total recurrence rate in the two years was 16.0% which was significantly lower than that of the control group (11.5%,25.0% and 36.5%,respectively).The quality of life in the two groups was improved significantly after the treatment,and the difference was statistically significant(P < 0.001).The score of the quality of life in experimental group was significantly higher than that of the control group(P < 0.001).Adverse reactions such as urinary pain,hematuria or frequent urination were found in 18 patients in experimental group,with an incidence rate of adverse reaction of 36.0%,which was significantly lower than that of the control group(57.7%)and the difference was statistically significant(P < 0.001).Conclusion Transurethral electrotomy combined with gemcitabine perfusion in elderly patients with non-myoinvasive bladder tumor can effectively reduce postoperative recurrence rate and the incidence of adverse reactions and improve the quality of life of the patients.