本文選題：膀胱癌　切入點(diǎn)：膀胱灌注　出處：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：比較吡柔比星(THP)單用療法、羥基喜樹(shù)堿(HCPT)單用療法、THP與HCPT聯(lián)合療法及THP與HCPT交替療法其四種膀胱灌注方法在淺表性膀胱癌術(shù)后治療的療效。方法：收集2002年5月至2010年5月來(lái)新疆醫(yī)科大學(xué)第二附屬醫(yī)院和第五附屬醫(yī)院診治的214例淺表性膀胱癌患者的臨床資料,均行經(jīng)尿道膀胱腫瘤切除術(shù)(TUR-BT),分成四組,術(shù)后均分別應(yīng)用THP單用療法、HCPT單用療法、THP與HCPT聯(lián)合療法及交替療法等四種膀胱灌注方法膀胱內(nèi)灌注治療,隨訪2年,觀測(cè)四組在3個(gè)月、6個(gè)月、9個(gè)月、12個(gè)月、18個(gè)月、24個(gè)月時(shí)的腫瘤復(fù)發(fā)率及灌注期間的不良反應(yīng)發(fā)生率。結(jié)果：比較術(shù)后3個(gè)月、6個(gè)月、9個(gè)月、12個(gè)月、18個(gè)月、24個(gè)月的復(fù)發(fā)率,THP+HCPT交替組與THP+HCPT聯(lián)合組的術(shù)后復(fù)發(fā)率均低于THP單用組、HCPT單用組(P0.0127),THP+HCPT交替組的術(shù)后復(fù)發(fā)率稍低于THP+HCPT聯(lián)合組(P0.0127),HCPT單用組稍低于THP單用組(P0.0127)。四組尿路刺激癥狀發(fā)生率分別為35.7%、32.7%、42.3%、15.7%,THP+HCPT交替組的尿路刺激癥狀發(fā)生率低于其余三組(P0.0127),其余三組尿路刺激癥狀發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.0127)。四組血尿發(fā)生率分別為20.8%、16.4%、26.9%、3.9%,THP+HCPT交替組的血尿發(fā)生率較其余三組低(P0.0127),其余三組血尿發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.0127)。四組肝、腎功能損害及血象異常發(fā)生率分別為10.7%、9.1%、15.4%、3.9%,THP+HCPT交替組肝、腎功能損害及血象異常發(fā)生率亦低于THP單用組、HCPT單用組和THP+HCPT聯(lián)合組(0.0127)。結(jié)論：淺表膀胱癌在行TUR-BT后,膀胱內(nèi)灌注THP+HCPT交替療法與THP+HCPT聯(lián)合療法預(yù)防膀胱癌術(shù)后復(fù)發(fā)療效確定,較THP單用療法、HCPT單用療法復(fù)發(fā)率低,且THP+HCPT交替療法的毒副作用低于其他三種療法,在臨床上可能更具備一定的推廣價(jià)值。
[Abstract]:Objective: to compare the efficacy of four bladder perfusion methods: pirarubicin (THP) alone, HCPT (hydroxy camptothecin) combined with HCPT and THP and HCPT in the postoperative treatment of superficial bladder cancer.Methods: the clinical data of 214 patients with superficial bladder cancer treated in the second affiliated Hospital and the Fifth affiliated Hospital of Xinjiang Medical University from May 2002 to May 2010 were collected. All patients underwent transurethral resection of bladder tumor and were divided into four groups.All the patients were treated with intravesical instillation of THP alone and HCPT combined with HCPT and alternating therapy respectively. The patients were followed up for 2 years.The recurrence rate of tumor and the incidence of adverse reactions during perfusion were observed at 3 months, 6 months, 9 months, 12 months, 18 months and 24 months in the four groups.The THP HCPT group was slightly lower than that of the THP group alone (P 0.0127).Conclusion: after TUR-BT is given to superficial bladder cancer, the curative effect of intravesical infusion of THP HCPT combined with THP HCPT in preventing recurrence of bladder cancer is determined, which is lower than that of THP alone.The toxicity and side effects of THP HCPT alternate therapy are lower than those of the other three therapies, which may be worth popularizing in clinic.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R737.14

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