以CO2为介质经尿道膀胱肿瘤电切术治疗膀胱肿瘤的初步研究

目的探讨以CO2为介质行经尿道膀胱肿瘤电切术（TURBT）治疗膀胱肿瘤的初步研究。方法以CO2为介质，采用充气膀胱镜技术，对26例膀胱肿瘤行经尿道膀胱肿瘤电切术，观察其对呼吸、循环系统的影响，评价其安全性、可行性，同时观察手术时间、术中出血量、住院天数、并发症、手术效果等。结果26例患者均操作顺利，平均手术时间17min（8-35min），术中微量出血，术中、术后无并发症发生。手术前、开始后10min及结束后30min的血压、心率、血氧饱和度值相比，差异无统计学意义（P〉0．05）。手术前、后对比血气分析中pH值、CO2分压值、O2分压值相比，差异无统计学意义（P〉0．05）。术后平均住院时间为5d（4－7d）。术后病理均为尿路上皮细胞癌。随访5－12个月肿瘤无复发。结论以CO2为介质对膀胱肿瘤进行TURBT治疗，视野清晰，出血少，安全有效，具有一定可行性。

Objective To investigate the clinical value of carbon dioxide pneumovesicum for transurethral resection of bladder tumor. Methods 26 cases of bladder tumor patients underwent transurethral resection of bladder tumor by carbon dioxide pneumovesicum were enrolled in the study in order to observe its impact on the respiratory and circulatory system and to evaluate the safety and feasibility. Meanwhile, The operation time, blood loss, hospitalization time, complications and operation effect were observed. Results All patients were operated successfully. The average operation time was 17min （ 8-35min ） , and there was no obvious bleeding. There was no complication occurred.Before the operation, the first 10 minutes and 30 minutes after the end of the comparative observation of blood pressure, heart rate, oxygen saturation value, allP〉0.05, the difference was not significant. Before and after the test, the changes of PH value ,CO2 partial pressnre,O2 partial pressure of blood gas analysis were compared, all P〉0.05, the difference was not statistically significant. The mean postoperative hospital stay was 5 days （ 5-7days ） . The all cases were urothelial carcinoma confirmed by postoperative pathology.The follow-up of 5-12 months, there was no tumor recurrence. Conclusion Carbon dioxide pneumovesicum technology for transurethral resection of bladder tumor is safe and feasible. It has a good endoscopic view and no obvious bleeding.