经尿道电切术和开放手术治疗早期膀胱癌的近期疗效分析

Comparison of short-term efficacy of transurethral resection and open operation for early bladder cancer

目的探讨经尿道膀胱肿瘤电切术(TURBT)和开放手术治疗早期膀胱癌的近期疗效。方法按照随机数字表法将102例早期膀胱癌患者分为研究组和对照组,每组51例。研究组患者接受TURBT治疗,对照组患者接受开放手术治疗。比较两组患者手术时间、术中出血量、留置导尿管时间、住院时间、并发症发生率及术后复发率。结果研究组患者的手术时间[(25.4±6.2)min]、术中出血量[(30.3±11.2)ml]、留置导尿管时间[(2.0±0.6)d]、住院时间[(5.5±1.1)d]均少于对照组的[(36.1±7.3)min、(58.2±12.2)ml、(3.0±0.8)d及(7.2±1.3)d],差异均有统计学意义(P<0.05)。研究组患者有2例(3.9%)发生尿道狭窄,其发生率低于对照组(13.7%,P<0.05);研究组患者膀胱穿孔(9.8%)及闭孔神经反射(11.8%)的发生率均高于对照组(0.0%、2.0%)(均P<0.05)。术后随访1年,两组均未见死亡病例,研究组有7例(13.7%)复发,对照组有8例(15.7%)复发,差异无统计学意义(P>0.05)。结论 TURBT治疗早期膀胱癌可改善患者手术情况,并能取得与开放手术相近的疗效,值得临床推广应用。

Objective To investigate the short-term efficacy of transurethral resection and open operation for early bladder cancer patients. Methods A total of 102 cases of early bladder cancer were divided into study group and control group according to the random number table,with 51 cases in each group.The study group received transurethral resection of bladder tumor（ TURBT）,and the control group were given open surgery. The operation time,bleeding volume,indwelling catheter time,hospitalization time and complication rate of the two groups were compared. Followed-uped for 1 year,the recurrence rate of the two groups was analyzed. Results The operation time [（ 25. 4 ± 6. 2） min ],bleeding volume [（ 30. 3 ±11. 2） ml],indwelling catheter time [（ 2. 0 ± 0. 6） d]and hospitalization time [（ 5. 5 ± 1. 1） d]of the study group were all less than those of the control group,which were [（ 36. 1 ± 7. 3） min,（ 58. 2 ± 12. 2）ml,（ 3. 0 ± 0. 8） d and（ 7. 2 ± 1. 3） d],respectively. And there were all statistically significant differences（ P 0. 05）. There were 2 cases（ 3. 9%） in the study group suffered from urethral stricture,which was lower than that of the control group（ 13. 7%）（ P 0. 05）. While incidence rate of the bladder perforation（ 9. 8%） and obturator nerve reflex（ 11. 8%） of the study group were all higher than those of the control group,which were 0. 0% and 2. 0%（ both P 0. 05）. Followed-uped for 1 year,there were no deaths in the two groups. The study group had 7 cases（ 13. 7%） recurrence,while there were 8 cases（ 15. 7%）in the control group,and there had no difference between two groups（ P 0. 05）. Conclusion TURBT can improve the operation of patients with early bladder cancer,and can get the similar effect with open operation,which is worthy of clinical application.