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作者自1991年采用Nd:YAG激光及膀胱灌注化疗治疗表浅性膀胱癌14例,取得良好效果,报告如下.1资料与方法1.1 一般资料 男12例,女2例,年龄33～72岁,均为Ta.T_1期的原发或复发肿瘤.最大1.0Cm×1.0cm2例,最多为4个,肉眼观非浸润性,病检为移行上皮乳头状瘤与移行细胞癌.1.2 方法 截石位,排空膀胱,消毒后2%利多卡因20ml注入尿道与膀胱行表面麻醉,插入膀胱镜,无菌蒸馏水充盈膀胱,观察肿瘤情况,插入操作镜,先行活检,再行激光照射,导光束为4Fr的石英纤维,电压24V,电流24mA,时间可为间断或连续自控.采取表面照射,使肿瘤表面及周围1.0cm粘膜热凝固.直至变为自苔,再将刀头分别插入肿瘤中心与肿瘤基底,使其产生热凝固,出血点照射至不出血为止,术毕立即行膀胱灌注化疗,丝裂霉素20～40mg或噻(口替)哌60mg,术后1个月行膀胱镜检,并重复激光照射及灌注化疗,以后每月膀胱灌注化疗1次,共6次,停止化疗,定期复查.
The authors since 1991 using Nd: YAG laser and bladder chemotherapy in the treatment of superficial bladder cancer in 14 cases, and achieved good results, the report is as follows.1 Materials and Methods 1.1 General Information Male 12 cases, female 2 cases, aged 33 to 72 years old, Are Ta.T_1 of the primary or recurrent tumor.Up to 1.0Cm × 1.0cm2 cases, up to 4, the naked eye concept of non-invasive, pathological examination of transitional epithelial papilloma and transitional cell carcinoma .1.2 Methods Stone , Empty the bladder, disinfect the lidocaine 2% lidocaine into the urethra and row surface anesthesia, insert the cystoscope, sterile distilled water filling the bladder, observe the tumor, insert the operating mirror, biopsy, then the laser irradiation, 4Fr quartz fiber, voltage 24V, current 24mA, the time can be intermittent or continuous self-control to take the surface irradiation, the tumor surface and around the 1.0cm mucous membrane thermal coagulation until it becomes from the moss, and then insert the tumor center and tumor The base, so that it produces thermal coagulation, bleeding point to the hemorrhage until the end of surgery immediately after surgery, bladder infusion chemotherapy, mitomycin 20 ~ 40mg or thiophene (oral) piperazine 60mg, 1 month after surgery cystoscopy, And repeat the laser irradiation and perfusion chemotherapy, chemotherapy once a month after bladder irrigation, 6, to stop chemotherapy, regular review.