经尿道电切术分别联合吉西他滨及吡柔比星膀胱灌注治疗老年膀胱癌的效果比较

Comparison of the effects of transurethral resection combined with gemcitabine or pirarubicin in the treatment of bladder cancer in the elderly

目的比较经尿道电切术分别联合吉西他滨、吡柔比星膀胱灌注治疗老年膀胱癌的效果。方法选择2015年11月-2017年11月于南京鼓楼医院集团宿迁市人民医院/徐州医科大学附属宿迁医院治疗的老年膀胱癌患者90例为研究对象,按照随机数字表法分为试验组和对照组各45例。试验组给予经尿道电切术联合吉西他滨膀胱灌注治疗,对照组给予经尿道电切术联合吡柔比星膀胱灌注治疗。比较2组患者治疗前、治疗6个月后匹兹堡睡眠质量指数量表(PSQI)评分,比较2组患者治疗后1年、2年肿瘤复发率及2年内不良反应发生率。结果治疗6个月后,2组患者PSQI各维度评分及总分均低于治疗前,且试验组低于对照组(P<0.05或P<0.01)。试验组患者治疗后1年、2年复发率均低于对照组(P<0.05)。治疗后2年内,试验组患者不良反应总发生率为22.22%,低于对照组的44.44%(χ^(2)=5.000,P=0.025)。结论经尿道电切术联合吉西他滨膀胱灌注治疗老年膀胱癌可更好控制肿瘤复发,改善患者睡眠质量,安全性更高,对患者预后更有利。

Objective To compare the effects of transurethral resection combined with gemcitabine or pirarubicin in the treatment of bladder cancer in the elderly.Methods 90 elderly patients with bladder cancer treated in Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group/Suqian Hospital Affiliated to Xuzhou Medical University from November2015 toNovember 2017 were selected as the research objects,and they were divided into the experimental group and the control group according to the random number table,45 cases in each group.The experimental group was given transurethral resection combined with gemcitabine bladder perfusion therapy,and the control group was given transurethral resection combined with pirarubicin bladder perfusion therapy.The pittsburgh sleep quality index(PSQI)scores of the two groups of patients before treatment and 6 months after treatment were compared,and the tumor recurrence rate within 1 year or 2 years of treatment and the incidence rates of adverse reactions within 2 years were analyzed in the two groups.Results After 6 months of treatment,the PSQI scores and total scores of the two groups were lower than before treatment,and the experimental group was lower than the control group(P<0.05 or P<0.01).The recurrence rates of patients in the experimental group were lower than those in the control group at 1 and 2 years after treatment(P<0.05).Within 2 years after treatment,the total incidence of adverse reactions in the experimental group was 22.22%lower than 44.44%in the control group(χ^(2)=5.000,P=0.025).Conclusion Transurethral resection combined with gemcitabine bladder perfusion for elderly bladder cancer can better control tumor recurrence and improve quality of sleep,and it has higher safety,and it is more beneficial to the prognosis of patients.