单次与多次膀胱灌注化疗对上尿路尿路上皮癌术后复发膀胱癌的影响

目的研究单次与多次膀胱灌注化疗对上尿路尿路上皮癌术后复发膀胱癌的影响。方法研究对象为2017年1月至2019年1月入院的46例上尿路尿路上皮癌术后患者,按照化疗方案划分为对照组(23例)与研究组(23例)两组,对照组选用单次膀胱灌注化疗,研究组选用多次膀胱灌注化疗,比较两组术后不良反应发生率、腹膜后肿瘤复发率及膀胱癌发生率。结果对照组术后出现1例膀胱刺激征,不良反应发生率为4.35%;研究组术后出现1例少量血尿,1例下尿路刺激征,不良反应发生率为8.70%,两组术后不良反应发生率差异无统计学意义(P>0.05)。对照组术后1例患者复发腹膜后肿瘤,发生率为4.35%;研究组术后无1例患者复发腹膜后肿瘤,两组术后腹膜后肿瘤复发率差异无统计学意义(P>0.05)。对照组术后发生9例膀胱癌,发生率为39.13%;研究组术后发生2例膀胱癌,发生率为8.70%,研究组术后膀胱癌发生率明显低于对照组(P<0.05)。结论多次膀胱灌注化疗可有效降低上尿路尿路上皮癌术后患者的膀胱癌发生率,对于预防膀胱癌具有积极作用,值得推广应用。

Effects of single and multiple bladder infusion chemotherapy on recurrent bladder cancer after urothelial carcinoma of the upper urinary tract

Objective To study the effect of single or multiple bladder infusion chemotherapy on recurrent bladder cancer after upper urinary tract urothelial carcinoma.Methods The research object is admitted to hospital between January 2017 and January 2019,46 patients with upper tract urothelial carcinoma postoperatively,according to the chemotherapy regimens are divided into two groups,one group of control group(23 cases),another group of research group(23 cases),the former group underwent a single bladder perfusion chemotherapy,another group umderwent multiple bladder perfusion chemotherapy.Two groups of postoperative incidence of adverse reactions,retroperitoneal tumor recurrence rate and the incidence of bladder cancer were compared.Results The incidence of adverse reactions was 4.35%in 1 case of bladder irritation in the control group,and 8.70%in 1 case of hematuria and 1 case of lower urinary tract irritation in the study group.There was no difference in the incidence of adverse reactions between the two groups(P>0.05).The recurrence rate of retroperitoneal tumor was 4.35%in 1 patient of the control group,and there was no recurrence of retroperitoneal tumor in 1 patient of the study group.There was no difference in the recurrence rate of retroperitoneal tumor between the two groups(P>0.05).The incidence of bladder cancer in the control group was 39.13%,while that in the study group was 8.70%.The incidence of bladder cancer in the study group was significantly lower than that in the control group(P<0.05).Conclusions Multiple bladder perfusion chemotherapy can effectively reduce the incidence of bladder cancer in patients with urothelial carcinoma in the upper urinary tract,and has positive effect on the prevention of bladder cancer,which is worthy of promotion and application.