经尿道等离子电切术联合吡柔比星治疗腺性膀胱炎238例报告

目的：评估经尿道等离子电切联合吡柔比星膀胱灌注治疗腺性膀胱炎的治疗效果。方法：对经膀胱镜及病理学检查确诊的238例腺性膀胱炎患者行经尿道等离子电切术，术后随机分为两组，一组118例术后即刻膀胱灌注单剂吡柔比星（灌注组），一组120例术后不灌注，常规随访观察（对照组）。结果：术后平均随访24（12～52）个月。灌注组有82例治愈，无病理学复发，症状缓解，术后半年复查膀胱镜见膀胱黏膜逐渐恢复为移行上皮覆盖；12例治疗后6～21个月病理学复发，1例3年内反复发作4次，行膀胱部分切除后治愈，无一例发生恶变；24例术后尿频、下腹痛症状仍然存在。对照组有61例治愈，无病理学复发，症状缓解；21例治疗后6～21个月病理学复发。经雨次电切和吡柔比星膀胱灌注后治愈；38例术后尿频、下腹痛症状仍然存在。结论：经尿道等离子电切足治疗腺性膀胱炎的有效方法，术后给予单剂吡柔比星即刻膀胱灌注化疗可提高治愈率。

Transurethral Plasmakinetic Resection Combined with Pirarubicin for Cystitis Glandularis(Report of 238 Cases)

Objective：To elevate the treatment of transurethral plasmakinetic resection combined with pirarubi cin for cystitis glandularis. Methods：238 cases of cystitis glandularis were diagnosed by cystoscopy and pathologi cal examination, and all cases were devided into two groups randomly. Bladder instillation of pirarubicin postoperation were performed immediately after transurethral plasmakinetic resection in 118 cases （instillation group）. 120 cases were not performed instillation after transurethral plasmakinetic resection （control group）. Routine followup was performed. Results：The follow-- up was ranged from 12 to 52 months with mean of 24 months. In instilla tion group, 82 cases were fully cured, no pathological relapse, and the symptoms relieved. Transitional cell covered tile surface of bladder mucosa gradually by cystoscopy. 12 cases were improved but relapsed within 6 to 21 months. 1 case relapsed four times in three years, and recovered after partial cystectomy. There is no any cases developed canceration. In contast group, 61 cases were fully cured without pathological recurrence, and the symp toms relieved. 21 cases were improved but relapsed within 6 to 21 months, and recovered after re--resection and bladder instillation of pirarubicin. 38 cases presented with urinary frequency, and the symptoms of abdominal pain after operation. Conclusions：Transurethral plasmakinetic resection is effective for the treatment of cystitis glandu laris. Immediate bladder instillation of pirarubicin after surgery can impove treatment outcome.