经尿道膀胱肿瘤汽化电切术联合表柔比星治疗非肌层浸润性膀胱癌的临床效果
[摘要]目的 探究经尿道膀胱肿瘤汽化电切术联合表柔比星治疗非肌层浸润性膀胱癌的临床效果。方法 选取2014年3月～2016年3月我院收治的40例非肌层浸润性膀胱癌患者随机分配的原则分为观察组（n=20）和对照组（n=20）。两组均给予经尿道膀胱肿瘤汽化电切术进行治疗，对照组加用羟喜树碱或米托蒽醌进行膀胱灌注，观察组加用表柔比星进行膀胱灌注，对比两组患者的导尿管留置时间﹑手术时间﹑不良反应及复发情况。结果 两组患者导尿管留置时间﹑手术时间比较，差异无统计学意义（P>0.05）；两组患者不良反应发生率比较，差异无统计学意义（χ2=0.28，P=0.60）；两组患者复发率比较，差异无统计学意义（χ2=0.20，P=0.66）。结论 经尿道膀胱肿瘤汽化电切术联合表柔比星治疗非肌层浸润性膀胱癌的效果确切，复发率低，值得推广。
[关键词]经尿道膀胱肿瘤汽化电切术；表柔比星；非肌层浸润性膀胱癌
[中图分类号] R737.1 [文献标识码] A [文章编号] 1674-4721（2018）2（b）-0089-03
Clinical effect of transurethral resection of bladder tumor combined with epirubicin in the treatment of non muscle invasive bladder cancer
HUANG Zhi-cheng PENG Dong CHEN Zhi-lin WAN Pei ZHU Yu-guang CHEN Nan-hui
The Four Department of Urology， Meizhou People"s Hospital in Guangdong Province， Meizhou 514000，China
[Abstract]Objective To explore the clinical effect of transurethral bladder tumor vaporizing electrotomy combined with epi in the treatment of non-muscular infiltrating bladder cancer.Methods 40 patients of non-muscle invasive bladder cancer treated in our hospital from March 2014 to March 2016 were divided into observation group （n=20） and control group （n=20）.Two groups were given transurethral electrovaporization of bladder tumor treatment，the control group with hydroxycamptothecin or mitoxantrone for bladder perfusion，observation group with epirubicin for bladder perfusion.The catheter indwelling time，operation time，adverse reactions and recurrence were compared between the two groups.Results There was no significant difference in indwelling time and operation time between the two groups （P>0.05）.There was no significant difference in the incidence of adverse reactions between the two groups （χ2=0.28，P=0.60）.There was no significant difference in recurrence rate between the two groups （χ2=0.20，P=0.66）.Conclusion Transurethral electrovaporization resection of bladder tumor combined with epirubicin in the treatment of non-muscle invasive bladder cancer is effective，the recurrence rate is low， worthy of promotion.
[Key words]Transurethral resection of bladder tumor；Epirubicin；Non muscle invasive bladder cancer
膀胱癌是发生于泌尿系统的常见恶性肿瘤之一，多来源于上皮组织，长期接触橡胶﹑塑料﹑染料等致癌物质，膀胱的长期炎症反应和异物的刺激及吸烟等均会诱发膀胱癌的发生[1-2]。膀胱癌在病理组织类型上主要表现为上皮性肿瘤，可占其总数的90%以上，只有少部分患者可表现为肉瘤或者横纹肌肉瘤等非上皮性肿瘤[3]。非肌层浸润性膀胱癌可包括TNM分期中的Tis﹑Ta﹑T1，针对Ta﹑T1期肿瘤，经尿道膀胱肿瘤电切术是临床上主要考虑的治疗方法。經尿道膀胱肿瘤汽化电切术对于表浅膀胱肿瘤可以有较好的治疗效果，但是基于膀胱癌的复发率较高，在手术的基础上常常会应用一些药物进行膀胱灌注化疗。表柔比星、羟喜树碱及米托蒽醌等是膀胱癌治疗中常用的行膀胱灌注的化疗药物[4]，因此，本研究对两种常用药物的效果进行了探索，希望可以为膀胱癌的治疗提供一种可靠的治疗方案，现报道如下。