吉西他滨膀胱内灌注预防膀胱癌术后复发的临床研究(附198例报告)

目的:研究吉西他滨膀胱内灌注预防经尿道膀胱肿瘤电切术(TURBT)术后复发的疗效。方法:对198例膀胱癌患者在TURBT术后行膀胱灌注治疗,随机分为两组:Ⅰ组(100例)定期行膀胱灌注吉西他滨,术后24h内使用1.0g,膀胱内灌注保留2h,1周后行常规灌注治疗,每周1次,连续8周,然后每月1次,连续10个月,共1年。Ⅱ组(98例)对照组灌注盐酸吡柔比星,术后24h内灌注使用30mg,膀胱内灌注保持30min,1周后开始常规灌注,每周1次连续8次,而后每月1次连续10次,共1年。结果:第1年每3个月复查膀胱镜,第2年每6个月复查膀胱镜。术后随访2年,Ⅰ组复发率6.52%,Ⅱ组复发率10.11%,术后不良反应主要是化学性膀胱炎症状。结论:膀胱癌术后灌注吉西他滨能有效预防膀胱癌的复发,且不良反应少,值得临床推广。

Clinical research of postoperative intravesical instillation of gemcitabine to prevent recurrence of bladder cancer（Report of 198cases）

Objective：To study the efficacy of intravesical instillation of gemcitabine in prophylaxis of recurrence after transurethral resection of bladder tumor（TURBT）.Method：Intravesical instillation was used in 198 patients for prophylaxis of recurrence after TURBT.These patients were divided into two groups.For groupⅠpatients（100cases）1.0g gemcitabine was instilled into bladder and retained for two hours the first day after operation.The instillation was performed once a week for eight weeks,and then once a month for one year.For groupⅡ patients（98cases）30mg pirarubicin was perfused into bladder and retained for 30 minutes the first day after operation.The instillation was performed once a week for eight weeks,and then once a month for one year.Result：The patients were followed up for two years.They were dealed with cystoscopy once every three months for the first year and once every six months for the second year.The recurrence rate were 6.52% and 10.11% in groupⅠ and groupⅡrespectively.The main adverse reaction was chemical cystitis.Conclusion：Intravesical instillation of gemcitabine is effective and safe in preventing local recurrence of bladder cancer after TURBT.It is worth popularizing clinically.