持续膀胱热灌注化疗技术方法的建立

目的：应用自主开发研制的BR-TRG-I型体腔热灌注治疗仪对膀胱癌患者进行膀胱内温热灌注化疗，探索并建立一种规范化持续循环恒温灌注的膀胱热灌注化疗技术方法。方法：对我院2009年3月～2010年9月收治的10例膀胱癌患者进行膀胱热灌注化疗，每例治疗1～4次，共治疗25例次。术前经尿道插入三腔导尿管至膀胱后固定，夹闭流出管，以其中一腔接灌注管，剩下一腔接流出管。灌注术在手术室或重症监护室内即可完成，术前仅需适当镇静止痛处理，无需特殊麻醉；灌注速度控制在150ml／min，灌注时间为40min，治疗温度为（45．O±0．2）℃，化疗药物选择丝裂霉素C（MMC）60mg，灌注液总量600ml；在灌注过程中实时监测患者生命体征。结果：10例患者膀胱热灌注化疗均顺利，调试仪器及放置导尿管、灌注管和引流管平均时间20min，灌注过程中能够实现持续循环恒温灌注，患者生命体征平稳，无与膀胱热灌注化疗相关的不良反应发生。结论：应用BR-TRG-I型体腔热灌注治疗仪对膀胱癌患者进行膀胱热灌注化疗，其技术方法安全可行，能够实现膀胱内持续循环恒温灌注化疗，有着很好的临床应用前景。

The Establishment of Technology and Methods of Bladder Continuous Hyperthermic Perfusion Chemotherapy

Objective：To explore and establish a standardized continuous circulate and constant temperature in- fusion technology and methods of hyperthermic perfusion chemotherapy on bladder cancer with the application of our self-developed BR-TRG-I type body cavity hyperthermic perfusion treatment system. Methods： From March 2009 t＇o September 2010,10 bladder cancer patients was treated with bladder hyperthermic perfusion chemotherapy in our hospital, each case treated for 1 to 4 times, with the tatol treatment of 25;Before the operation, three-cavity catheter was inserted into the bladder through urethra and fixed, clamp and close the outflow pipe, connect one of the cavity to the perfusion tube,the other connect drainage tube. The therapy can be completely conducted in the operation room or Intensive Care Unit,it just need the adequate preoperative sedation analgesia disposal,no special anesthesia;infusion speed eontroled at 150 ml/min,with the temperature of （45.0±0.2）℃ treated for 40 minutes, the chemotherapy drug was Mitomyein C（MMC）, 60 mg MMC dissolved in 600 ml perfusate, vital signs of the patient was for real-time monitored during the perfusion process. Results：The bladder hyperthermic perfusion chemotherapy process of the 10 patients was conducted successfully. The average time of prepare work about adjusting the instrument and placing the catheter was 20 minutes;In the process of perfusion,the BR-TRG-I type hyperthermic body cavity perfusion treatment system can achieve the continuous circulate of thermostatic perfusion,and the vital signs of the patients could keep stable, there are not adverse reactions occur related to the bladder hyperthermic perfusion chemotherapy. Conclusions：The application of bladder hyperthermic perfusion chemotherapy on bladder cancer patients through BR-TRG-I type body cavity hyperthermie perfusion treatment system, the tech nology and methods is safe and feasible, which could achieve the continuous circulate of thermostatic perfusion, and has very bright clinical application prospect.