吡喃阿霉素术中黏膜下注射与术后早期膀胱灌注预防浅表膀胱癌部分切除术后复发的疗效

摘要

目的：探讨吡喃阿霉素术中黏膜下注射与术后早期膀胱灌注预防浅表膀胱癌部分切除术后复发的疗效。方法回顾性分析浅表膀胱癌部分切除术后68例患者的临床资料，根据应用吡喃阿霉素方式方法的区别分为观察A组32例，观察B组36例，观察A组术中给予吡喃阿霉素膀胱黏膜下注射，而观察B组则在术前6 h内和术后1周给予术后早期的吡喃阿霉素膀胱灌注。2组患者均在术后2周给予常规吡喃阿霉素常规膀胱灌注。对患者术后情况进行记录和对比分析，随访期3年。结果观察B组术后血尿平均天数为（1．8±0．8）天，其中3例出现鲜红色血尿，其余均为淡红色血尿；观察A组术后血尿平均天数为（5．9±1．3）天，患者均出现过鲜红色血尿，并伴有絮状组织。2组患者术后血尿天数差异具有统计学意义，t＝4．82，P＜0．05。2组患者3年随访期内复发情况组间均无明显差异，P＞0．05。结论吡喃阿霉素术中黏膜下注射和术后早期膀胱灌注都能显著降低浅表膀胱癌部分切除术后的复发率，且差异无统计学意义，但吡喃阿霉素术后早期膀胱灌注对减少术后血尿时间更具优势，值得临床推广应用。%Objective To observe and discuss the clinical efficacy of intraoperative submucosal injection of pirarubicin and postoperative early bladder perfusion of pirarubicin for recurrence of superficial bladder cancer after partial resection .Meth-ods Clinical data of 68 patients after superficial bladder cancer after partial resection were retrospectively analyzed .According to different application methods of pirarubicin ,the patients were divided into group A with 32 cases and group B with 36 cases. Group A was treated with intraoperative submucosal injection of pirarubicin while group B was treated with postoperative early bladder perfusion of pirarubicin within 6h before operation and 1 week after operation .Both groups were given routine bladder per-fusion of pirarubicin 2 weeks after operation .Conditions of all patients after operation and within 3-year follow-up were recorded , analyzed and compared .Results Hematuresis condition after operation of the 2 groups showed that ,average duration of hematu-resis of group B was(1.8 ±0.8)d,there were 3 cases of bright red hematuresis and the rest were light red hematuresis ,average duration of hematuresis of group A was (5.9 ±1.3)d,all cases had bright red hematuresis with flocculent tissues (t=4.82,P<0.05).There was no significant difference between the 2 groups in recurrence during 3-year follow-up(P>0.05).Conclusion Intraoperative submucosal injection of pirarubicin and postoperative early bladder perfusion of pirarubicin can both obviously re -duce recurrence of superficial bladder cancer after partial resection ,there are no significant differences .Postoperative early bladder perfusion of pirarubicin is more effective in reducing hematuresis ,and it is worthy of being popularized clinically .