1470 nm半导体激光联合膀胱灌注在非肌层浸润性膀胱肿瘤中的安全性和有效性分析

Analysis of the safety and efficacy of 1470 nm semiconductor laser combined with intravesical instillation in non-muscle invasive bladder neoplasms

目的探讨应用1470 nm半导体激光联合膀胱灌注在治疗非肌层浸润性膀胱肿瘤中的安全性和有效性。方法回顾性分析84例经术后病理证实为非肌层浸润性膀胱肿瘤患者的临床资料,按手术方式分为研究组即应用1470 nm半导体激光联合膀胱灌注治疗组(40例)和对照组即经尿道膀胱肿瘤电切术(TURBT)联合膀胱灌注治疗组(44例)。收集并比较两组患者的手术时间、术中出血量、平均住院时间,术后并发症及术后肿瘤复发率等指标。结果两组患者均顺利完成手术。研究组患者术中出血量明显少于对照组,住院时间明显短于对照组,差异均有统计学意义(P﹤0.01)。两组的术后并发症比较,除闭孔反射外,差异均无统计学意义(P﹥0.05)。术后1 d,两组患者的血清C反应蛋白(CRP)及白细胞水平均有所升高,但研究组患者的血清CRP及白细胞水平明显低于对照组(P﹤0.01)。两组患者术后3个月、6个月和1年时的复发率和平均复发时间比较,差异均无统计学意义(P﹥0.05)。结论应用1470 nm半导体激光联合膀胱灌注在非肌层浸润性膀胱肿瘤中操作简单,术后恢复快,是治疗非肌层浸润性膀胱肿瘤的一种安全、有效的治疗方式,值得临床上广泛推广。

Objective To investigate the safety and efficacy of 1470 nm semiconductor laser combined with intravesical instillation in the treatment of non-muscle invasive bladder tumor. Method A retrospective analysis was performed in 84 patients with pathologically confirmed non-muscle invasive bladder tumor, these patients were administered with1470 nm semiconductor laser combined with intravesical instillation（study group, n=40）, or transurethral resection of bladder tumor（TURBT） combined with intravesical instillation（control group, n=44）. The average operative time, intraoperative blood loss, average hospital stay, incidence of postoperative complications, and postoperative recurrence rate of the two groups were collected and compared. Result All patients had successfully completed surgical treatment. Compared with the control group, patients in the study group had less intraoperative blood loss and shorter hospital stay（P〈0.01）. The incidence of postoperative complications were similar between the two groups except obturator reflex（P〈0.05）; in 1 day after surgery, the serum CRP and WBC were increased in all patients, while those in study group were significantly lower than in control group（P〈0.01）. There was no significant difference in regard of the recurrence rate and average time to recurrence at 3 months, 6 months and 1 year after surgery between the two groups（P〈0.05）. Conclusion The application of 1470 nm semiconductor laser combined with intravesical instillation has the advantages of simple operation, and may promote rapid postoperative recovery, which is a safe and effective therapy in the treatment of non-muscle invasive bladder cancer.