丝裂霉素C术中膀胱粘膜下注射加术后膀胱内灌注预防膀胱肿瘤术后复发的研究

目的　探讨丝裂霉素C术中膀胱粘膜下注射加术后膀胱内灌注预防膀胱肿瘤术后复发的效果。方法　将 2 3 6例膀胱癌术后患者随机分为两组 :A组 12 0例 ,用丝裂霉素C 8～ 10mg加生理盐水 60～ 80ml行术中粘膜下注射 ,然后用丝裂霉素C10mg加生理盐水 3 0ml行术后膀胱内灌注 ;B组 116例 ,丝裂霉素C10mg加生理盐水 3 0ml行术后膀胱内灌注。每周 1次 ,8次后改为每月 1次 ,连续 2年半以上。结果　随访 6个月～ 6年 ,A组复发 12例 ,复发率为 10 .0 % ;B组复发 43例 ,复发率为 3 7.0 %。两组比较差异有显著性 ,χ2 =2 4.18,P <0 .0 1。结论　丝裂霉素C术中膀胱粘膜下注射加术后膀胱内灌注预防膀胱肿瘤复发疗效优于单用丝裂霉素C膀胱内灌注。

Prevention of tumour reoccurrence by injecting Mitomycin C in bladder mucous membrane during surgery plus perfusing it inside bladder after surgery

Objective To evaluate the efficacy of Mitomycin C in prevention tumor reoccurrence by injecting it in bladder mucous membrane during surgery plus perfusing it inside bladder after surgery. Methods 236 patients were ramdonly divided into two groups: Group A, n=120; and Group B, n=116. Group A received the therapy of Mitomycin C 8～10mg plus normal saline 60～80ml, injected in the mucous membrane during surgery, then Mitomycin C 10mg plus normal saline 30ml were perfused inside bladder; and Group B was given the regimen of Mitomycin C 10mg plus normal saline 30ml perfused inside bladder after surgery. Once every week; eight times later, it was reverted to once every month and lasted for more than two and a half years. Results During the follow-up from 6 months to 6 years, it was found that 12 cases reoccurred in Group A, the reoccurrence rate was 10.0%; and 43 cases reoccurred in Group B, the reoccurrence rate was 37.0%. There was statistically significant difference between these two groups, χ 2=24.18, P<0.01. Conclusions In the prevention of tumor reoccurrence, injecting Mitomycin C in the bladder mucous membrane pluse perfusing it inside bladder had better effectiveness than single perfusing Mitomycin C inside bladder.