早期吡柔比星膀胱内灌注预防膀胱癌术后复发

目的:探讨膀胱肿瘤电切术(TURBt)后早期应用吡柔比星灌注化疗预防肿瘤复发的疗效。方法:对112例病理证实的膀胱移行细胞癌患者,59例行早期灌注(Ⅰ组),53例行常规灌注(Ⅱ组)。Ⅰ组于术后6小时内将30mg吡柔比星溶于40ml蒸馏水膀胱内灌注,保留2小时后排出,术后7天开始规律膀胱灌注;Ⅱ组于术后7天开始吡柔比星规律膀胱灌注,比较两组患者膀胱肿瘤复发率。结果:随访7~54个月,平均35个月,Ⅰ组6例膀胱肿瘤复发,Ⅱ组13例复发,差异有统计学意义;不良反应包括尿路刺激征、肉眼血尿等,两组比较差异无统计学意义。结论:TURBt后早期开始吡柔比星膀胱灌注化疗,可以显著降低膀胱肿瘤复发率。     

吡柔比星灌注预防膀胱癌术后复发40例

目的:探讨吡柔比星膀胱灌注化疗预防浅表性膀胱癌术后复发的疗效.方法:40例行经尿道膀胱肿瘤切除术或膀胱部分切除术病人,术后定期膀胱内灌注吡柔比星,每周1次,共8次.之后每月1次.共10次.结果:40例患者定期随访12～24个月,3例肿瘤复发.结论:吡柔比星膀胱灌注预防膀胱癌术后复发疗效显著,无明显副作用.     

吡柔比星膀胱灌注预防浅表性膀胱癌术后复发

目的：评价吡柔比星（THP）膀胱内灌注预防浅表性膀胱癌术后复发的近期疗效。方法：对34例浅表性膀胱癌患者行经尿道膀胱肿瘤电切术（TURBt)或膀胱部分切除术，术后定期用THP（30mg/40ml）作膀胱内灌注，每周1次共8次，以后每月1次共1年。每次药物在膀胱内保留40min。结果：经10－12个月随访，无肿瘤复发32例，复发2例，复发率为5．9％；未见全身性药物不良反应，仅5例患者出现轻度膀胱刺激症状。结论：THP膀胱内灌注预防浅表性膀胱癌术后得发近期疗效满意，副作用轻，耐受性良好。     

术中黏膜下注射氮芥与术后即刻灌注吡柔比星预防非肌层浸润性膀胱癌术后复发的临床研究

目的 探讨比较经尿道膀胱肿瘤电切(TUR-Bt)术中膀胱黏膜下注射盐酸氮芥与术后即刻灌注吡柔比星(THP)化疗预防非肌层浸润性膀胱癌复发的疗效.方法 将64例行TUR-Bt术的膀胱癌患者随机分为A、B两组,A组34例术中膀胱黏膜下注射盐酸氮芥;B组30例于手术后采用吡柔比星膀胱灌注.观察各组肿瘤复发情况、毒副反应.结果 A组平均随访37.1个月,4例复发,复发率11.8％;B组平均随访36.2个月,7例复发,复发率23.3％,两组之间差异有统计学意义(P＜0.05).所有患者未见明显的全身性药物反应.结论 术中黏膜下注射盐酸氮芥和术后早期膀胱灌注吡柔比星显著降低非肌层浸润性膀胱癌术后复发率,其中术中黏膜下注射优于术后早期灌注,两组之间副作用无明显差异.     

吡柔比星术后即刻膀胱灌注联合常规灌注预防表浅性膀胱癌术后复发的对照研究

目的：比较吡柔比星两种膀胱内灌注方法预防表浅性膀胱癌术后复发的有效性及安全性。方法：将52例经尿道膀胱癌电切术后表浅性膀胱癌患者随机分为两组。每次吡柔比星灌注剂量30mg,治疗组术后24h内膀胱灌注1次,此后每周灌注1次,连续8周,再改为每月灌注1次,至术后1年。对照组术后2周开始灌注,此后每周灌注1次,连续8周,再改为每月灌注1次,至术后1年。结果：全部病例均获随访,时间为12～24个月,平均随访16．3个月。其中治疗组随访期内2例复发,复发率8％;对照组随访期内4例复发,复发率14％,两组复发率比较差异有统计学意义（P〈0．05）,不良反应主要为尿路刺激症状。结论：本研究显示,吡柔比星膀胱灌注预防表浅性膀胱癌术后复发的疗效满意,用药方便,患者耐受性好;术后即刻膀胱灌注联合常规灌注较常规灌注可以降低肿瘤复发率,值得推荐。     

TUR-BT术后吡柔比星即刻膀胱灌注预防非肌层浸润性膀胱癌复发的疗效观察

目的观察经尿道膀胱肿瘤切除术(TUR-BT)后吡柔比星(THP)即刻膀胱灌注预防非肌层浸润性膀胱癌(NMIBC)复发的临床疗效。方法回顾性分析2000~2009年收治的301例非肌层浸润性膀胱癌行经尿道膀胱肿瘤切除术患者,随机分为治疗组(184例)和对照组(117例),治疗组术后24小时内行即刻膀胱灌注,对照组术后未行24小时内即刻膀胱灌注,随访比较两组患者的复发情况。结果患者术后24小时内行即刻膀胱灌注与肿瘤复发风险相关(HR=2.564,P0.0001),但与肿瘤进展风险无关,治疗组和对照组无复发生存时间有显著的统计学差异(P0.0001)。结论经尿道膀胱肿瘤切除术后24小时内行吡柔比星即刻膀胱灌注是预防非肌层浸润性膀胱癌复发有效的治疗方法。     

经尿道膀胱肿瘤电切术后膀胱灌注吡柔比星治疗浅表性膀胱肿瘤42例报告

目的探讨吡柔比星膀胱灌注对治疗浅表性膀胱癌术后复发的预防效果。方法42例患者,在行经尿道膀胱肿瘤电切术（TURBt）术后定期经导尿管给予膀胱内灌注吡柔比星30mg／40ml,每周1次,每次膀胱内保留60min,共8次,术后3个月行1次膀胱镜检查。结果共有4例复发。42例患者有不同程度的膀胱区不适,3例症状较重。结论吡柔比星膀胱内灌注预防肿瘤术后复发疗效显著、安全、可靠。     

经尿道膀胱电切术后吡柔比星灌注治疗表浅性膀胱癌临床分析

目的总结膀胱肿瘤电切术（transurethral resection of bladder tumor,TURBt）加吡柔比星（tetrahydnopyrany adriamyrin,THP）灌注治疗表浅性膀胱癌的疗效。方法48例表浅性膀胱癌患者,均行TURBt,术毕用THP40mg＋注射用水40ml行灌注化疗30min,术后每周化疗1次,共8次,然后改为每个月1次,持续1年。结果均顺利完成手术,术中未出现膀胱穿孔、膀胱出血等并发症。48例患者平均随访2.1（0.5~3）年,术后1年内6例在非原来位置复发（12.5%）,再次行TURBt加THP灌注,随访1年无复发。结论TURBt加THP膀胱灌注疗效确切,可降低复发率,是治疗表浅膀胱癌的有效方法。     

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。     

浅表膀胱癌TURBt术后吡柔比星膀胱保留灌注化疗预防复发的随访研究

目的随访观察浅表膀胱癌经尿道膀胱肿瘤电切术（TURBt）后毗柔比星膀胱保留灌注化疗对干预膀胱癌复发的影响。方法选取浅表膀胱癌TURBt术后患者109例,分为观察组62例和对照组47例。术后,对照组未给予膀胱保留灌注化疗,观察组予以膀胱保留灌注吡柔比星治疗．随访2年．观察两组的复发率,以及观察组膀胱保留灌注化疗的不良反应。结果术后3～6个月内,对照组膀胱癌复发率呈下降趋势,此后呈逐渐升高的趋势;观察组各时间段内膀胱癌复发率基本呈现降低趋势;两组累积复发率均呈逐渐升高的趋势,但观察组累积复发率升高趋势平缓,而对照组累积复发率升高趋势急剧。各时间段内观察组膀胱癌复发率、累积复发率均低于对照组（P〈0．05）。结论吡柔比星膀胱保留灌注化疗有效降低了浅表膀胱癌TURBt术后膀胱癌的复发率,且未出现严重的不良反应,临床应用比较安全,对预防TURBt术后膀胱癌复发具有积极而重要的干预意义。     

Absorption Kinetics of Rectal Formalin Instillation

Med. J. Aust. 1:23, 1969). Although its use is widespread, no studies have been performed to determine the safest volume or duration of formalin exposure. The purpose of our study was to determine the optimum technique for instillation and the safety margin regarding the maximum time that formalin can be in contact with the rectal mucosa without causing serum toxicity. In a pilot canine study, 4% neutral buffered formalin was instilled into the rectum in 30 ml aliquots for 60 seconds each after which each aliquot was withdrawn; a total volume of 400 ml was used. Our subsequent experiment involved rectal instillation of a single formalin bolus of 100 ml for 1 hour without removal during this time. Formalin metabolites were measured in the blood and urine to assess toxicity. Results indicate that with the latter technique serum formic acid reaches toxic levels within 15 minutes of instillation and may stay elevated for several hours. Metabolites in the urine similarly increase within 15 minutes, lagging only shortly behind the rise in serum levels. Performing formalin instillation in a series of 30 ml aliquots appears to be a safer treatment, as toxic serum levels were not reached and their slight rise above baseline returned to normal within 3 hours.     

子宫输卵管通液的B型超声所见

目的本研究的目的是利用子宫输卵管通液术在B 型超声显像下,观查子宫输卵管腔内所见,探讨能否以之代替子宫输卵管碘油造影术。     

沙培林联合羟基喜树碱膀胱灌注与单独灌注预防膀胱癌术后复发疗效对比观察

目的：评价联合应用沙培林（OK-432）和羟基喜树碱（HCPT）膀胱腔内灌注及单独应用预防膀胱癌复发的疗效。方法：128例膀胱乳头状移行细胞癌患者行经尿道电切术和膀胱部分切除术后,随机分为3组：联合治疗组36例,OK-432组42例,HCPT、组50例。膀胱癌切除术后开始灌注,每周1次,共8周;以后每月1次,随访18个月。每2个月复查1次膀胱镜和尿细胞学检查。结果：联合应用组无复发,OK-432组3例复发,复发率7．14％（3／42）,HCPT组5例复发、复发率10．00％（5／50）。OK-432组与HCPT组比较差异无统计学意义（P〉0．05）;但二者与联合组比较,组间差异有统计学意义（P〈0．05）。三组均无严重不良反应和并发症。结论：联合应用OK-432、HCPT疗效优于单独应用,预防复发疗效好,不良反应不明显,有较高临床应用价值。     

Intravesical Instillation Treatment of Non–muscle-invasive Bladder Cancer

Bacillus Calmette-Guérin (BCG) is a proven and valuable adjunct to transurethral resection (TUR) for decreasing recurrence and progression of non–muscle-invasive bladder cancer (NMIBC). The European Association of Urology (EAU) and American Urological Association (AUA) have similar recommendations for induction and maintenance treatment in patients based on clinical and pathologic risk factors. To most effectively treat this disease, clinicians must be aware of the risk factors for treatment failure, strategies to deal with failures and BCG intolerance, and the appropriate threshold to proceed with radical cystectomy (RC). Combination, alternative, and multimodal intravesical treatments for patients with BCG failure have arisen in recent years, and the outcomes data are reviewed here.     

Instillation of silver nitrate in the treatment of chyluria.

A series of 62 patients with chyluria received instillations of 1% silver nitrate in the renal pelvis over an 8-year period; 51 patients responded well but 11 showed no response to treatment. Follow-up ranged from 2 to 7 years. The treatment was found to be safe, effective and minimally invasive.     

Instillation of Alcohol into Venous Malformations of the Head and Neck

Vascular malformations are errors of vascular morphogenesis, and must be differentiated from vascular tumours such as haemangiomas, because the natural history and treatment are different. Vascular malformations may be arterio-venous with high blood flow, or venous with low blood flow. Venous vascular malformations grow among soft tissues and are difficult to delineate at operation. Direct puncture under fluoroscopy with injection of contrast medium is one method of visualising the cavities of a venous malformation. Instillation of concentrated alcohol directly into such cavities is a possible treatment. Forty-four patients with venous malformations of the head or neck have been treated since 1984, of whom 31 responded to a follow up questionnaire. Twenty-three responded to injection of ethanol alone, and eight also required reconstructive surgery; 26 of the 31 described the result as “good” or “excellent” (84%).