3种方法经膀胱镜治疗膀胱肿瘤

Three managements of bladder tumors under cystoscopy

目的:探讨膀胱镜下治疗膀胱肿瘤的几种方法。方法:总结比较膀胱镜下3种治疗方法:肿瘤蒂部注射复方硫酸铝、经尿道膀胱肿瘤电切(TURBT)、应用钬激光治疗膀胱肿瘤。结果:瘤蒂部注射复方硫酸铝治疗膀胱癌1174例,操作简单,经济实用,无闭孔神经反射,肿瘤无原位复发,但对大而且无蒂的肿瘤并不合适;TURBT700例,需要有一定的操作技术及设备,过程中需注意止血及闭孔神经反射,有部分原位复发;应用钬激光治疗膀胱肿瘤34例,有3例异位复发,无原位复发,需钬激光操作设备。结论:3种方法在膀胱镜下对膀胱肿瘤治疗均有效但各有利弊,应视病人具体病情选择最佳治疗方案,具体操作时交叉使用互补以获取最好的疗效。

Objective To discuss three managements of bladder tumors under cystoscopy. Methods Of all the patients, 1174 were injected compound aluminum sulphate in tumor pedicle, and 700 cases were treated with transurethral resection of bladder tumor （TURBT） and 34 cases were treated with holmium laser. Results The first management, without obturator nerve reflex and tumor recurrence in situ, was easy and economical but not fit for big tumors without pedicles. With the requirements for related techniques and equipments, TURBT might be accompanied by bleeding, obturator nerve reflex and tumor recurrence in situ. Of the 34 cases treated with holmium laser, there were 3 ones with ectopic recurrence and no one with recurrence in situ. With the requirement for holmium laser equipment, the third management was the most expensive one. Conclusion All of the three managements have their advantages and disadvantages. The doctor should select the right management or perform cross application according to the condition of the patient.