表柔比星与甘露聚糖肽联合灌注治疗膀胱癌术后的疗效分析

发布时间：2018-04-09 06:00

本文选题：膀胱癌术后　切入点：表柔比星　出处：《青海大学》2017年硕士论文

【摘要】：目的:探究两种作用机制不同的药物表柔比星(epirubicin,EPI)和甘露聚糖肽(mannatide)联合灌注治疗膀胱癌术后的疗效。方法:收集病例共92例,按照就诊的顺序随机分组:A组(29例)用表柔比星40mg溶解于0.9%氯化钠注射液30ml;B组(32例)用40mg甘露聚糖肽溶解于0.9%氯化钠注射液30ml;C组(31例)用40mg表柔比星+40mg甘露聚糖肽溶解于0.9%氯化钠注射液30ml。手术方式均为经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT),术后1周开始规律灌注,灌注治疗均为一人操作,并严格按照无菌原则实施,通过随访比较三组患者术后的复发及不良反应发生情况。结果:对三组患者随访1年,A组、B组和C组患者1年内的膀胱癌复发率分别为31.03%(9/29)、34.38%(11/32)、3.22%(1/31),经统计学分析,A组和B组差异无统计学意义(P0.0125),而C组分别与A、B组比较,差异均有统计学意义(P0.0125)。A、B、C三组患者不良反应:膀胱刺激征发生率分别为48.28%、3.13%、16.13%,经统计学分析,A组与B、C两组的差异均有统计学意义(P0.0125),B、C两组差异无统计学意义(P0.0125);肉眼血尿发生率分别为17.24%、0%、6.45%,三组患者两两比较,差异均有统计学意义。结论:EPI和甘露聚糖肽联合使用对于预防膀胱癌术后复发的疗效优于单一使用EPI或甘露聚糖肽,且毒副作用小,安全性高,值得临床推广;单独使用EPI和甘露聚糖肽的抗肿瘤效果无明显差异,但EPI的不良反应明显高于甘露聚糖肽;因研究时间有限,远期效果需更高层次的探究。
[Abstract]:Aim: to explore the efficacy of epirubicinine epirubicin (EPI) and mannose polypeptide (MGP) in the treatment of bladder cancer after operation.Methods: 92 cases were collected.Thirty two patients in group B were dissolved with epirubicin 40mg in 0.9% sodium chloride injection. 32 patients in group B were treated with 40mg mannose polypeptide dissolved in 0.9% sodium chloride injection. 31 patients in group C were treated with 40mg epirubicin 40mg.Glycopeptide was dissolved in 0.9% sodium chloride injection 30 ml.Transurethral resection of bladder tumor TURBT were all performed by transurethral resection of bladder tumor. Regular perfusion was performed 1 week after operation. The perfusion therapy was performed by one person and was performed strictly according to the principle of sterility.The recurrence and adverse reactions of the three groups were compared by follow-up.The incidence of bladder irritation was 48.28 and 3.13 respectively. The difference between group A and group B was statistically significant (P 0.0125). There was no significant difference between group A and group B (P 0.0125), and there was no significant difference between group C and group B (P 0.0125); the incidence of bladder irritation was 48.28% and 3.13%, respectively. There was no significant difference between group A and group B (P 0.0125), and there was no significant difference between group A and group B (P 0.0125), and there was no significant difference between group A and group B (P 0.0125).The birth rates were 17.24% and 6.45%, respectively.The difference was statistically significant.Conclusion the combined use of 1: EPI and mannopolyglycopeptide is more effective than EPI or mannopolyglycopeptide in preventing recurrence of bladder cancer after operation, and its toxicity is small and safety is high, so it is worth popularizing in clinic.There was no significant difference in antitumor effect between EPI and mannopoly-glycopeptide alone, but the adverse reaction of EPI was significantly higher than that of mannopoly-glycopeptide. Because of the limited research time, the long-term effect needed to be explored at a higher level.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.14

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