经尿道膀胱肿瘤电切术联合膀胱灌注治疗膀胱肿瘤的临床观察

Clinical Observation of Transurethral Resection of Bladder Tumor Combined with Bladder Instillation for Bladder Cancer

目的:探讨经尿道膀胱肿瘤电切术联合膀胱灌注在治疗膀胱肿瘤中的临床效果。方法:选择我院2012年2月~2016年2月期间经尿道膀胱肿瘤电切术治疗膀胱肿瘤患者65例,术后定期给予丝裂霉素C、噻替哌、吡柔比星等药物膀胱腔内灌注化疗,并定期随访,观察患者术后复发及不良反应等情况。结果:本组65例患者经尿道膀胱肿瘤电切术后膀胱肿瘤复发率36.7%、不良反应发生率33.8%,且复发率随着膀胱肿瘤病理分级的增高而逐渐增高,相互之间差异具有统计学意义;电切术后联合膀胱灌注治疗,复发率16.7%、不良反应发生率15.4%,与单纯的电切术治疗相比,复发率和不良反应发生率差异均具有统计学意义;三种不同灌注药物治疗患者的复发率及不良反应发生率差异均无统计学意义。结论:采用经尿道膀胱肿瘤电切术联合膀胱灌注治疗膀胱肿瘤,二者相得益彰,可以有效降低术后膀胱肿瘤的复发率,减少不良反应,提高治疗效果,值得临床进一步推广与应用。

Objective To investigate the clinical effect of transurethral resection of bladder tumor combined with bladder instillation for bladder cancer. Methods 65 cases of bladder cancer patients in our hospital were selected from February 2012 to February 2016. All patients were treated with transurethral resection of bladder tumor. After the operation, regularly given mitomycin C, thiotepa, pirarubicin intravesical instillation of chemotherapy drugs, and regular follow-up to observe the postoperative recurrence and adverse reactions. Results The group of 65 patients by transurethral resection of bladder tumor postoperative bladder tumor recurrence rate of 36.7% and adverse reaction incidence rate of 33.8% restriction, and the recurrence rate with pathological grading of bladder cancer increased gradually increased, the difference between each other with statistical significance. After transurethral resection of bladder tumor combined with bladder instillation, the recurrence rate was 16.7% and the incidence of adverse reactions was 15.4%. There was a significant difference between recurrence rate and adverse reaction rate. There was no significant difference in the recurrence rate and incidence of adverse reactions between the three different types of drug infusion. Conclusion Using transurethral resection of bladder tumor combined with bladder instillation for bladder cancer, the two complement each other, can effectively reduce the recurrence rate of bladder cancer after operation, reduce adverse reaction, improve the therapeutic effect. It is worthy of further popularization and application.