膀胱癌药敏试验指导膀胱灌注远期疗效观察.doc

膀胱癌药敏试验指导膀胱灌注远期疗效观察 　　作者：张爱莉 赵志红 倪晓辰 弓艳霞 　　作者单位：050011 石家庄市，河北医科大学第四医院泌尿外科 　　【摘要】目的 探讨膀胱癌药敏试验指导膀胱灌注的远期疗效。方法 将80例非肌层浸润性膀胱癌患者随机分为药敏组和对照组，每组40例，2组均行经尿道膀胱肿瘤电切术。术后药敏组根据药敏试验结果选择化疗药物进行膀胱灌注，对照组根据经验随机应用化疗药物灌注，2组均为单药灌注。随访24～72个月。结果 2组所有患者均获得随访。药敏组复发7例，复发率17.5%;对照组复发12例，复发率30.0%，2组比较差异有统计学意义(P0.05)。结论 肿瘤药敏试验指导膀胱癌患者膀胱灌注化疗药物的选择，能显著地降低膀胱癌的复发率，具有良好的远期疗效。 　　【关键词】 膀胱肿瘤 药物敏感试验 腔内灌注 　　Long term effect of drug sensitivity test for intravesical instillation for bladder cancer 　　ZHANG Aili，ZHAO Zhihong，NI Xiaochen，et al.　　Department of Urology，The Fourth Affiliated Hospital of Hebei Medical University，Shijiazhuang 050011，China 　　【Abstract】 Objective To evaluate the long term effect of drug sensitivity test for intravesical instillation for bladder cancer.Methods 80 patients with noninvasive bladder cancer after TURBt were divided into two groups randomly：40 cases of drug sensitivity group received intravesical instillation according the results of drug sensitivity test;40 cases of control group were given intravesical instillation basing on the experience of doctors.All the patients were followed up for 24 to 72 months.Results All of the two groups were followed up，recurrence rate was 17.5%(7/40)in drug sensitivity group and 30%(12/40)in control group.The difference was significant(P0.05).Conclusion Drug sensitivity test for the selection of drugs for intravesical instillation can reduce the recurrence rate of bladder cancer significantly and 1improve the longterm efficiency of treatment of bladder cancer. 　　【Key words】 bladder tumor;drug sensitivity test;intravesical instillation 　　2002年1月至2006年1月我院对40例非肌层浸润性膀胱癌患者行经尿道膀胱肿瘤电切术，术后将手术标本进行药敏试验，根据试验结果选择化疗药物行膀胱灌注，并与随机用药的40例患者进行比较，以探讨药敏试验应用的临床意义。 　　1 资料与方法 　　1.1 一般资料 　　非肌层浸润性膀胱癌患者80例，其中男45例，女35例;年龄29～82岁，平均年龄64.6岁。64例为初发;16例为复发。所有患者均行经尿道膀胱肿瘤电切术，术后经病理证实均为膀胱移行细胞癌。将患者随机分为药敏组与对照组，每组40例;2组病例在肿瘤数目、临床分期、病理分级等方面差异均无统计学意义(P0.05)。见表1。表1 2组病程分级及肿瘤分期比较　(略) 　　1.2 治疗方法 　　将药敏组的手术标本进行药敏试验，根据结果选择最敏感的一种化疗药物进行膀胱灌注;对照组