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目的采用生存分析的方法对照研究化疗栓塞与化疗灌注在中、晚期膀胱癌中的治疗作用。资料与方法69例中、晚期膀胱癌患者分为两组,一组行双侧髂内动脉化疗灌注术,另一组行双侧髂内动脉化疗栓塞术。应用Cox比例风险模型对各个因素与术后膀胱癌的生存时间进行回归分析,筛选出主要的影响因素;应用Kaplan-Meier生存曲线分析两种治疗方法与生存时间的关系,并进行Log-Rank检验。结果69例手术均成功,双侧髂内动脉化疗栓塞术组生存时间为5~52个月,平均(26.52±3.29)个月;双侧髂内动脉化疗灌注术组生存时间为4~36个月,平均(13.41±1.69)个月。中晚期膀胱癌的死亡率与介入治疗的两种方法的相关性差异有统计学意义(P<0.05),其风险度为3.220,回归系数为1.169,证明双侧髂内动脉化疗栓塞术对于提高患者的生存时间具有更重要的意义。接受双侧髂内动脉化疗栓塞术的患者,生存时间明显高于接受双侧髂内动脉化疗灌注术的患者。结论应用化疗栓塞治疗较单纯化疗灌注治疗可明显提高患者的生存时间。
Objective To investigate the therapeutic effect of chemoembolization and chemoembolization in the treatment of middle and advanced stage of bladder cancer by means of survival analysis. Materials and Methods 69 cases, advanced bladder cancer patients were divided into two groups, one group bilateral iliac artery chemotherapy infusion, the other group underwent bilateral internal iliac artery chemoembolization. Cox proportional hazards model was used to analyze the relationship between various factors and postoperative survival time of bladder cancer, and the main influencing factors were screened out. The Kaplan-Meier survival curves were used to analyze the relationship between the two treatment methods and the survival time, and Log-Rank test . Results All the 69 cases were successful. The survival time of bilateral internal iliac artery chemoembolization group was 5 to 52 months with an average of (26.52 ± 3.29) months. The survival time of bilateral internal iliac artery chemotherapy infusion group was 4 to 36 Month, with an average of (13.41 ± 1.69) months. There was significant difference between the two methods in the treatment of advanced bladder cancer and interventional therapy (P <0.05), the risk was 3.220 and the regression coefficient was 1.169, which proved that bilateral internal iliac artery chemotherapy and embolization was more effective The patient’s survival time is more important. In patients undergoing bilateral internal iliac artery chemoembolization, the survival time was significantly higher than those undergoing bilateral internal iliac artery chemoembolization. Conclusion Chemotherapy and embolization can significantly improve the survival time of patients compared with chemotherapy alone.