【摘要】：目的：評(píng)價(jià)術(shù)前予吡柔比星膀胱灌注對(duì)非肌層浸潤(rùn)性膀胱癌患者的復(fù)發(fā)和進(jìn)展的影響。方法：收集135例行經(jīng)尿道膀胱腫瘤電切術(shù)(TUR-BT)治療的非肌層浸潤(rùn)性膀胱癌患者。根據(jù)納入和排除標(biāo)準(zhǔn),最后獲得符合標(biāo)準(zhǔn)的120例患者。灌注組40人,術(shù)前半小時(shí)用吡柔比星30mg+5%葡萄糖50m1行膀胱灌注,而后行TUR-BT;對(duì)照組80例,術(shù)前未予膀胱灌注。灌注組和對(duì)照組均于TUR-BT術(shù)后2周開(kāi)始用吡柔比星30mg+5%葡萄糖50m1行膀胱灌注,1次/周,共8周；而后1次/月,至術(shù)后1年,術(shù)后均隨訪1年,每3個(gè)月行膀胱鏡檢查明確腫瘤有無(wú)復(fù)發(fā)、進(jìn)展。結(jié)果：隨訪術(shù)后1年內(nèi),灌注組40例復(fù)發(fā)7例,復(fù)發(fā)率17.5%,進(jìn)展2例,進(jìn)展率5%；對(duì)照組80例復(fù)發(fā)28例,復(fù)發(fā)率35%,進(jìn)展6例,進(jìn)展率7.5%。在EORCT評(píng)分表分組的中危組中,兩組的復(fù)發(fā)率分別為16.8%和36.7%。兩組的總體進(jìn)展率的差異無(wú)統(tǒng)計(jì)學(xué)意義；兩組總體復(fù)發(fā)率和EORCT評(píng)分表分組的中危組中的差異具有有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：術(shù)前行吡柔比星膀胱灌注能降低非肌層浸潤(rùn)性膀胱癌術(shù)后1年的復(fù)發(fā)率,尤其是按EROCT評(píng)分表分組的中危組的患者,是降低非肌層浸潤(rùn)性膀胱癌術(shù)后復(fù)發(fā)率的一個(gè)有效方法。
[Abstract]:Objective: to evaluate the effect of intravesical instillation of pirarubicin on recurrence and progression of non-myometrial invasive bladder cancer. Methods: a total of 135 patients with non-muscular invasive bladder cancer were treated with transurethral resection of bladder tumor (TUR-BT). According to the inclusion and exclusion criteria, 120 patients who met the criteria were obtained. 40 patients in the perfusion group received intravesical instillation of pirarubicin 30mg 5% glucose 50m1 half an hour before operation, and 80 patients in the TUR-BT; control group were given intravesical perfusion without intravesical instillation before operation. Both the perfusion group and the control group received intravesical instillation of pirarubicin 30mg 5% glucose 50m1 at 2 weeks after TUR-BT for 8 weeks, followed by 1 month to 1 year after operation. Cystoscopy was performed every 3 months to determine the recurrence and progression of the tumor. Results: within one year of follow-up, there were 7 cases of recurrence, 17.5% of recurrence, 2 cases of progression and 5 cases of progression in perfusion group, while in the control group, there were 28 cases of recurrence, 35% of recurrence rate, 6 cases of progression, and 7.5% of progress rate. The recurrence rates of the two groups were 16.8% and 36.7%, respectively. There was no significant difference in the overall progression rate between the two groups; there was significant difference in the overall recurrence rate between the two groups and in the middle risk group in the EORCT scoring table (P0.05). Conclusion: preoperative intravesical instillation of pirarubicin can reduce the recurrence rate of non-myometrial invasive bladder cancer 1 year after operation, especially in the moderate risk group according to the EROCT score. It is an effective method to reduce the recurrence rate of non-myometrial invasive bladder cancer.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R737.14

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