摘要:目的 探讨非肌层浸润性膀胱尿路上皮癌患者行经尿道膀胱肿瘤电切术(TURBT)后铜绿假单胞菌-甘露糖敏感血凝菌毛株(pseudomonas aeruginosa-mannose sensitive hemaggluti-nin,PA-MSHA)和吡柔比星膀胱灌注治疗的有效性及安全性. 方法 选取行TURBT的非肌层浸润性膀胱尿路上皮癌患者91例,根据膀胱灌注药物的不同分为实验组(41例)和对照组(50例),实验组患者术后24 h内膀胱灌注PA-MSHA,对照组患者术后24 h 内膀胱灌注吡柔比星,随访患者规律灌注后的不良反应及肿瘤复发情况. 结果 实验组发生急性膀胱炎3例,血尿3例,发热2例,胃肠道反应1例,不良反应发生率为21.95%(9/41);复发例数为10例,术后6个月复发3例,术后12个月复发5例,术后24个月复发2例,总复发率为24.39%(10/41).对照组发生急性膀胱炎8例,血尿5例,发热5例,胃肠道反应3例,不良反应发生率为42.00%(21/50);复发例数为11例,术后6个月复发6例,术后12个月复发4例,术后24个月复发1例,总复发率为22.00%(11/50). 结论 PA-MSHA 和吡柔比星两种灌注药物对于预防非肌层浸润性膀胱癌患者TURBT术后复发的疗效差异无统计学意义,但两者不良反应的发生率存在差异,PA-MSHA的不良反应发生率低于吡柔比星.%Objective To compare the safety and efficacy between pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA)and pirarubicin for intravesical instillation after tran-surethral resection of bladder tumor (TURBT)in patients with non-muscle-invasive bladder transi-tional epithelial carcinoma. Methods Ninety-one cases of non-muscular infiltrating bladder transi-tional epithelial cancer who underwent TURBT were enrolled.TURBT after excluding related surgi-cal contraindications,then in 24 hours the experimental group,41 cases received intravesical infusion of PA-MSHA,while the control group,50 cases received intravesical instillation of pirarubicin.Pa-tients were followed up regularly,and adverse reactions and recurrence of perfusion were observed. Results In the experimental group,3 cases of bladder irritation,3 cases of hematuria,2 cases of fe-ver and 1 case of gastrointestinal reaction were found.The incidence of adverse reactions was 21.95%(9/41).The number of recurrent cases was 10,3 cases recurred 6 months after operation,5 cases recurred 12 months after operation,and 2 cases recurred 24 months after operation.The total recur-rence rate was 24.39% (10/41).In the control group,8 cases of bladder irritation,5 cases of hema-turia,fever in 5 cases,3 cases of gastrointestinal reactions were found.The incidence of adverse re-actions was 42.00% (21/50).The number of recurrent cases was 11,6 cases recurred in 6 months, 4 cases recurred in 12 months and 1 case recurred in 24 months,the total recurrence rate was 22.00%(11/50). Conclusions There was no statistically significant difference in the efficacy between PA-MSHA and pirarubicin in preventing the recurrence of non-muscle-invasive bladder cancer after TURBT.However,there was significant difference in the incidence of adverse reactions between the two,and the incidence of adverse events in PA-MSHA was lower than that of piraru-bicin.