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[摘要] 目的 探讨经尿道钬激光切除联合吡柔比星灌注治疗浅表性膀胱癌的疗效。 方法 2008年2月～2011年6月，我科收治71例浅表性膀胱癌患者，随机分为对照组和治疗组两组。对照组35例患者采用经尿道膀胱癌电切术治疗；治疗组36例患者采用经尿道钬激光膀胱癌切除术治疗，术后即刻予膀胱内无菌蒸馏水60 mL加吡柔比星30 mg灌注1次。两组术后拔除导尿管时予无菌蒸馏水60 mL加吡柔比星30 mg灌注1次，以后每周1次，连续灌注8周后改为每个月1次，持续灌注至术后1年。 结果 对照组平均手术时间为32.5 min，1例发生术中膀胱穿孔，术后留置导尿管时间平均6 d，9例患者术后复发；治疗组平均手术时间为33.4 min，术中未出现膀胱穿孔，术后留置导尿管时间平均3 d，2例患者术后复发。两组之间平均手术时间、膀胱穿孔例数无统计学差异（P > 0.05），治疗组术后导尿管留置时间、肿瘤复发例数均低于对照组（P < 0.05）。 结论 经尿道钬激光切除联合吡柔比星灌注治疗浅表性膀胱癌的效果优于单纯电切术，术后复发率低、患者恢复快，临床效果好，值得临床推广应用。
[关键词] 浅表性膀胱癌；激光手术；钬激光；吡柔比星；局部灌注
[中图分类号] R737.14 [文献标识码] B [文章编号] 1673-9701（2012）30-0157-02
Clinical analysis of treating superficial bladder carcinoma using transurethral holmium laser resection combine with instant intravesical Pirarubicin instillation
JIA Hongbo ZHONG Wei
Department of Urinary Surgery，the Affiliated Coal General Hospital of Hebei United University，Beijing 100028，China
[Abstract] Objective To investigate the application and clinical result of treating superficial bladder carcinoma using transurethral holmium laser resection combine with instant intravesical pirarubicin instillation. Methods Between February 2008 to June 2011，71 patients with superficial bladder carcinoma were treated in our department. They were divided into two groups according to the random digits table. The 35 patients in the control group were treated with transurethral electroresection. The 36 patients in the observation group were treated with transurethral holmium laser resection combine with instant intravesical pirarubicin instillation. The intravesical pirarubicin instillation was immediately after operation with 60mL distilled water combine with 30 mg pirarubicin. The above intravesical pirarubicin instillation was done again when urethral catheter was extracted in the two groups. The instillation was performed once a week until eight weeks later. The instillation was performed once a month in the later one year. Results In the control group，the mean operation time was 32.5 min；there was one patient had vesical perforation during operation；the mean time of indwelling urethral catheter was 6d；and there were nine patients with recurrence.In the observation group，the mean operation time was 33.4 min；there was no patient had vesical perforation during operation； the mean time of indwelling urethral catheter was 3 d；and two were three patients with recurrence. No significant deviation was observed in the two groups in the operation time and vesical perforations（P > 0.05）. Significant deviation of the time of indwelling urethral catheter and the recurrence was observed in the two groups（P < 0.05）. Conclusion Transurethral holmium laser resection combine with instant intravesical pirarubicin instillation is an effective method compare with transurethral electroresection in treating superficial bladder carcinoma. It has low recurrence rate with good clinical result.
[关键词] 浅表性膀胱癌；激光手术；钬激光；吡柔比星；局部灌注
[中图分类号] R737.14 [文献标识码] B [文章编号] 1673-9701（2012）30-0157-02
Clinical analysis of treating superficial bladder carcinoma using transurethral holmium laser resection combine with instant intravesical Pirarubicin instillation
JIA Hongbo ZHONG Wei
Department of Urinary Surgery，the Affiliated Coal General Hospital of Hebei United University，Beijing 100028，China
[Abstract] Objective To investigate the application and clinical result of treating superficial bladder carcinoma using transurethral holmium laser resection combine with instant intravesical pirarubicin instillation. Methods Between February 2008 to June 2011，71 patients with superficial bladder carcinoma were treated in our department. They were divided into two groups according to the random digits table. The 35 patients in the control group were treated with transurethral electroresection. The 36 patients in the observation group were treated with transurethral holmium laser resection combine with instant intravesical pirarubicin instillation. The intravesical pirarubicin instillation was immediately after operation with 60mL distilled water combine with 30 mg pirarubicin. The above intravesical pirarubicin instillation was done again when urethral catheter was extracted in the two groups. The instillation was performed once a week until eight weeks later. The instillation was performed once a month in the later one year. Results In the control group，the mean operation time was 32.5 min；there was one patient had vesical perforation during operation；the mean time of indwelling urethral catheter was 6d；and there were nine patients with recurrence.In the observation group，the mean operation time was 33.4 min；there was no patient had vesical perforation during operation； the mean time of indwelling urethral catheter was 3 d；and two were three patients with recurrence. No significant deviation was observed in the two groups in the operation time and vesical perforations（P > 0.05）. Significant deviation of the time of indwelling urethral catheter and the recurrence was observed in the two groups（P < 0.05）. Conclusion Transurethral holmium laser resection combine with instant intravesical pirarubicin instillation is an effective method compare with transurethral electroresection in treating superficial bladder carcinoma. It has low recurrence rate with good clinical result.