不同高频功率经尿道电切在糖尿病罹患膀胱癌术后创面愈合的临床观察

Clinical observation of wound healing in diabetic bladder cancer patients after transurethral resection of different high frequency power

目的：探讨不同高频功率经尿道电切对糖尿病罹患膀胱患者癌术后创面愈合的影响。方法采用不同高频功率经尿道电切治疗糖尿病罹患膀胱癌患者38例，对患者治疗及随访情况进行回顾性分析。结果38例患者随访3～50个月，高功率电切组12例创面隆起伴有膀胱黏膜肉芽肿等炎症表现，其表面有钙质与絮状物形成的包壳覆盖，活检提示纤维素样炎性增生，未发现肿瘤复发。低功率电切组24例中有6例创面不平且有类结石物附着，活检结果纤维素样炎性增生。随访期间高功率电切组12例中2例术后11个月复发，即刻灌注患者4例未见复发。低功率电切组24例中在6～12个月4例复发，即刻灌注患者19例中有2例复发。结论膀胱浅表性非浸润性膀胱肿瘤罹患糖尿病患者在有效控制血糖的前提下，采用低功率高频电切，同时配合即刻灌注治疗能够明显降低创面延迟愈合的发生，是一种可选择的治疗方法。

Objective To analyze the power of different frequency of transurethral resection on effects of wound healing after operation in terms of diabetes among patients with bladder cancer. Methods Using different high frequency power transurethral resection in treatment of diabetic patients with bladder cancer in 38 cases,the treatments and follow-up of patients were analyzed retrospectively from Feb. 2010 to Apr. 2014. Results 38 patients were followed up for 3 - 50 months. In the high power-cutting groups,12 patients were found having the bladder mucosa with granulomain flammatory performance;the biopsy results were cellulose hyperplasia,no tumor recurrence. In the fasting blood glucose control,high-power cutting group,12 cases had different degree of bladder mucosa granuloma in？flammatory performance;operation wound was a calculus class floccules fiber and calcium original sedimentary formation of appressoria, biopsies in hyperplasia of fiber;no tumor recurrence was found. Low power cut wounds of 6 patients showed a volcano change and stone structures,fibrous hyper-plasiabiopsy results. Within the 11 months of the follow-up period with the high power cutting group,two ca？ses recurred and four patients had no recurrence of immediate perfusion. For the low power electric cutting groups,four cases had recur？rence within 6 - 12 months;among the 19 patients with immediate perfusion,there were two cases of recurrence. It was found that in the low power cutting group were 6 samples of postoperative which were a lot of stone-like objects attached to its surface;biopsy results were cellulose hyperplasia. During the follow-up period,2 patients in the high power-cutting group had tumor recurrence 11 months after the operation. In four cases of using the immediate perfusion therapy,tumor recurrence did not happen to patients. But four patients had recur？rence in the low power cutting group within 6 - 12 months,and two cases were observed with tumor recurrence among 19 cases of using immediate perfusion therapy. Conclusion In the premise of effective control of blood glucose,using low power high frequency electric knife for non invasive bladder cancer patients with diabetes,the method of treatments using immediate perfusion super-facial bladder can significantly reduce the wound after the operation of delayed healing. This is an alternative method of treatment.