膀胱灌注预防表浅性膀胱癌术后复发.doc

膀胱灌注预防表浅性膀胱癌术后复发 　　作者： 张峰 陆鸿海 杨坤 　作者单位:200090上海市杨浦区中心医院泌尿外科 　　【摘要】 目的 降低表浅性膀胱癌术后复发率。方法 147例表浅性膀胱癌术后分为3组:(1)卡介苗组50例，卡介苗150mg加生理盐水60ml，行膀胱灌注;(2)丝裂霉素组77例，丝裂霉素20mg加生理盐水40ml，行膀胱灌注;(3)无膀胱灌注组20例。膀胱灌洗每周1次，连续6次，然后2周1次，连续6次，以后每月1次，总疗程2年。结果 经5年随访，卡介苗组复发12例，复发率24%;丝裂霉素组复发26例，复发率33.8%;无膀胱灌注组复发14例，复发率70%。3组比较差异有显著性(P0.01)。结论 卡介苗、丝裂霉素单药膀胱灌注都有预防表浅性膀胱肿瘤术后复发的疗效。 　　关键词 膀胱肿瘤 表浅性 卡介苗 丝裂霉素 灌注法 预后 　　Postoperative bladder perfusion to prevent recurrence of superficial bladder cancer 　　Zhang Feng，Lu Honghai，Yang Kun 　　Department of Urology，Yangpu District Central Hospital，Shanghai，200090 　　【Abstract】 Objective To reduce the recurrence rate of primary superficial transitional cell bladder cancer.Methods 147cases with superfacial bladder cancer were divided into three groups after surgery:(1)Group A，50cases treated with bacillus Calmette-Guerin(BCG)，150mg BCG plus60ml normal saline to be infused into the bladder，(2)Group B，77cases treated with Mitomycin C(MMC)，being infused into the bladder at the dosage of20mg Mitoˉmycin C plus40ml normal saline，(3)Group C，20cases with no bladder perfusion.Above Intravesical instillation were used once a week for6weeks，then once every two weeks for6weeks and subsequently once a month until two years.Results After5years follow-up，there were12cases(24%)，26cases(33.8%)，14cases(70%)of bladder canˉcer recurrence in the patients treated with BCG，MMC，and with no bladder perfusion respectively.There was remarkable difference between three groups(P0.01).Conclusion Intravesical instillation of BCG or MMC was efficacious for the prevention of postoperative recurrence of superficial bladder cancer. 　　Key words Bladder cancer superficial Bacillus Calmette-Guerin Mitomycin C Perfusion Prognosis 　　我院于1985年1月～1999年1月，应用卡介苗、丝裂霉素分别对50例、77例表浅性膀胱癌术后患者行膀胱灌注防治膀胱癌复发，并与20例术后未行膀胱灌注患者对比，现报告结果如下。 　　1 资料与方法 　　1.1 临床资料 对147例在我院诊治并获得随访的表浅性膀胱癌患者进行回顾性分析。男 122例，女25例;年龄29～89岁，平均63.5岁。单发肿瘤95例;多发肿瘤52例。行经尿道膀胱肿瘤电切(TURBt)者96例，膀胱部分切除者51例。全部病例均经病理检查证实为膀胱移行细胞