摘要目的 观察不同保留时间膀胱灌注吡柔比星对预防表浅性膀胱癌术后复发的影响.方法 选择泌尿外科住院治疗的68例吡柔比星膀胱灌注治疗的表浅性膀胱癌术后患者为研究对象,随机将其分为对照组和观察组,于术后2周内开始吡柔比星膀胱灌注,每次灌注后妥善固定并保留气囊导尿再按规定变换体位,2组的保留灌注时间分别为15 min和30 min.20 mg/次,每周1次共8次,以后每个月1次共1年,观察2组患者的生存时间及复发情况.结果 观察组表浅性膀胱癌患者中位生存期为15个月,生存时间范围3 ～ 24个月.对照组表浅性膀胱癌患者中位生存期为11个月,生存时间范围3～ 24个月；对照组表浅性膀胱癌患者复发率(38.24％)明显高于观察组的(14.71％),2组表浅性膀胱癌患者复发率差异有统计学意义(x2=4.836,P=0.028).结论 吡柔比星膀胱内保留灌注30 min预防表浅性膀胱癌术后复发的疗效满意,复发率明显低于保留灌注15 min者,保留药物在膀胱内的同时保留导尿管的方法可保护尿道,避免化学性尿道炎的发生,值得推广运用.

abstractsObjective To investigate the influence on preventing the relapse of bladder cancer by pirarubicin irrigation ot bladder with different retaining time.Methods Sixty - eight cases of post - operative bladder superficial cancer irrigated with pirarubicin were selected.and divided into two groups randomly.Two weeks after operation pirarubicin bladder irrigation began.After every irrigation a well stabilized indwelling air - bulb catheter was used and the patient's lying posture changed routinely.The pirarubicin retaining time of these two groups were 15 minutes and 30 minutes respectively.Every time 20 mg of pirarubicin were used.This was done once every week and lasted for eight weeks.After this the irrigation is done once every month,and continued for 1 year.The patients'survival time and relapse rate were observed and compared.Results The average survival time of the first group was 15 months,while that of control group was 11 months.The relapse rate of the control group was 38. 24％ and it was by far higher than that of the first group ( 14.71％ ).The difference was significant. Conclusions The prevention of post - operative bladder cancer relapse - by pirarubicin bladder irrigation with a retaining time of 30minutes is a very satisfactory method.The relapse rate is lower than that of only retaining 15 minutes.Use of an indwelling air - bulb catheter can protect the urethra from chemical injury.It is worthy widely spreading.