两种方法行THP膀胱内灌注预防膀胱癌术后复发的疗效观察

目的：探讨膀胱癌术后大剂量吡喃阿霉素（THP）膀胱内灌注时保留时间对肿瘤复发和对人体安全性的差异。方法：将45例浅表性膀胱癌经尿道膀胱肿瘤电切术或膀胱部分切除术病人随机分对照组（24例）、观察组（21例），二术后2周开始应用THP（40mg/40ml）膀胱内灌注，观察组灌注后药物在膀胱内保留30min；对照组保留2h。结果：两组病人随访7－26个月，复发率比较，P＞0．05，差异无显著性意义；所有病人均能耐受THP膀胱内灌注；两组灌注后不同保留时间全身不良反应比较，均P＞0．05，差异无显著性意义；尿频、尿痛等膀胱刺激症和迟发性不良反应（尿道狭窄和前列腺炎）两组比较，P＜0．05，观察组明显低于对照组。结论：膀胱癌术后应用THP膀胱内灌注预防肿瘤复发效果显著，药物在膀胱内保留时间短，对膀胱、尿道刺激性小，不良反应少。

Prevention of Recurrence of Postoperative Bladder Cancer by Tow Ways of Intra-bladder Infusion with Pirarubicin Hydrochloride

Objective To investigate the relationship between intra-bladder infusion retaining time and tumor recurrence or human safety with large dose of pirarubicin hj'drochloride for injection (THP) in postoperative bladder cancer. Methods Forty-five cases of superficial bladder cancer subject to bladder cancer resection through urethra by electrotherapy or partial cystectomy were randomly divided into two groups: observation group (n=21) with drug retained for 30 min bladder infusion with THP (40 mg/40 ml) 2 weeks after operation. Control group (n = 24) with drug retained for 2 h respectively. Results The follow-up period was 7-26 months in both groups. There was no significant difference in the recurrence rate between the two groups (P>0. 05). All patients could tolerate intra-bladder infusion with THP. There was no significant difference in retaining time and general side effects after infusion between the two groups (P>0. 05). The occurrence of the irritative symptoms of bladder and delayed side effects in the observation group was significantly lower than in the control group (P<0. 05). Conclusion Intra-bladder infusion with THP to prevent the recurrence of bladder cancer after operation had a satisfactory effectiveness. The shorter drug retaining time in bladder, milder irritative reaction and side effects.