经导管动脉化疗栓塞治疗在晚期膀胱癌合并出血中的作用

摘要

目的 探讨经导管动脉化疗栓塞术(TACE)在控制晚期膀胱癌的膀胱出血以及控制肿瘤生长中的作用.方法 选择2015年1月～2016年12月海军总医院收治的43例晚期膀胱癌并肉眼血尿患者,采用经导管膀胱动脉灌注化疗并用栓塞微球栓塞供血动脉,30 d后再重复治疗1次,观察膀胱出血止血成功率、肿瘤病灶缩小情况以及肿瘤降期的情况.结果 第1次TACE后所有患者膀胱出血均得到控制,止血成功率为100％.第2次治疗后30 d,MRI提示肿瘤体积缩小大于50％者27例(62.8％),12例(28.0％)患者获得降期,肿瘤分期与术前比较差异有统计学意义(P＜0.05).未见严重副作用和并发症.结论 TACE可以有效控制晚期膀胱癌的膀胱出血,并对肿瘤生长有明显抑制的作用.%Objective To investigate effects of transcatheter arterial chemoembolization (TACE) in the treatment of controlling the bladder bleeding and inhibiting the tumor growth in advanced bladder cancer.Methods From January 2015 to December 2016,in Navy General Hospital,43 patients with advanced bladder cancer and gross hematuria were selected,they were treated with bladder arteries chemoembolization (TACE).All the patients presented macroscopic haematuria.The catheters were inserted into bladder supplying arteriesand anticancer drugs infusion and followed by embolization with microsphere.Procedures were repeated 30 d after the first treatment.The success rate of hemostasis,shrinkage of tumor and downstage of tumors after TACE was observed.Results Bladder bleeding stopped after the first TACE in all patients.Bladder tumor shrinkageof more than 50％ in 27 patients (62.8％) was found by MRI 30 d after the second treatment.Down stage of tumors were found in 12 patients (28.0％).The differences of tumor stage between pre and post treatment were statistical significant (P ＜ 0.05).No serious side effects and complications were developed in all patients.Conclusion TACE is effective in controlling bladder bleeding in advanced bladder cancer.The tumor growth is significantly inhibited by the procedures.