摘要
目的:比较苯扎溴铵(BB)和吡柔比星(THP)膀胱内灌注预防浅表性膀胱移行细胞癌(SBTCC)术后复发的有效性及安全性。方法:将120例SBTCC患者术后随机分成2组,BB组60例,术后立即膀胱内灌注1‰BB300ml,并保留灌注液15分钟,共1次。THP组60例,THP30mg溶于50mL生理盐水中,膀胱灌注,每周1次,共8次,然后改为每月1次,持续1年。定期膀胱镜检查进行随访。结果:随访24个月,BB、THP组的复发率分别为6.6和20.0,BB组明显低于THP组(P<0.05),其中高分化、单发、初发肿瘤、BB膀胱灌注较低分化、多发、复发肿瘤以及THP膀胱灌注的复发率低。而肿瘤大小和手术方式对患者的复发率的影响无差异。BB组的尿路刺激症状、血尿和WBC<4×109/L发生率分别为5.0、1.7和0,THP分别为16.7、11.7和8.3,BB组低于THP组(P<0.05)。2组肝肾功能受损发生率无差异。结论:BB膀胱灌注预防SBTCC术后复发的效果明确,疗效较THP好,费用低廉,无明显全身毒副作用,患者耐受性好。由于观察病例数较少,随访时间不长,远期疗效如何有待进一步积累临床资料和长期随访。
Objective： Compare the effect and safety of bzalkonium bromide （BB）and pirarubicin（THP） by bladder instillation after transurethral resection or partial cyslectomy of superficial bladder transient cell carcinoma （SBTCC）. Methods ：120 patients of SBTCC who underwent transurethral resection of bladder tumor （TURBt） or partial cyslectomy were divided into 2 groups. BB group （60 cases） received intravesical instillation of 0. 1% bzalkonium bromide 300 ml and retained for 15 min for one time. THP group （60 cases） received intravesical instilla- tion of 30 mg THP plus 50 ml NS once a week,8 weeks later once a month for 1 year. Cystoscopy was performed every 3 months, 1 year later once 6 months and side effects were monitored. Results：All patients were followed up 24 months. The tumor recurrent rate in BB group and THP group were 6.6% and 20.0% ,respectively. The tumor recurrent rate of the bzalkonium bromide differed significantly from the pirarubicin group （ P〈0.05）. There was a significant difference in the recurence rate between well and poorly differentiated tumor, single and multiple tumors,primary and recurring tumor, tumor intravesical instillation of BB and THP （ P〈0.05）, but no difference of recurence rate was found between different tumor size and operative method. The side effects rate of the two groups, BB group was lower than THP group in the lower urinary tract symptoms, haematuria and abnormal blood WBC （ P〈0.05）, but there was no significant difference between 2 groups in liver function and kidney function. Conclusions： Intravesical administration of bzalkonium bromide after operation was more effective than THP, which had the merit of low cost and was well-tolerated for preventing tumor recurrence with not obvious side effects. The clinical ramifications of these findings need to be addressed as the follow-up time was short.
出处
《临床泌尿外科杂志》
2008年第7期502-505,共4页
Journal of Clinical Urology
关键词
膀胱肿瘤
苯扎溴铵
吡柔比星
膀胱内灌注
Bladder neoplasms
Bzalkonium bromide
Pirarubicin
Bladder instillation
