经尿道膀胱肿瘤钬激光切除术及经尿道膀胱肿瘤电切术治疗非肌层浸润膀胱癌临床疗效观察

Effects of transurethral holmium laser resection and transurethral resection of bladder tumor for patients with nonmuscle invasive bladder cancer

目的比较经尿道膀胱肿瘤钬激光切除术(HOLRBT)及经尿道膀胱肿瘤电切术(TURBT)在非肌层浸润膀胱癌(NMIBC)患者治疗的临床疗效。方法选取自2015年3月至2017年5月江油市人民医院收治的100例NMIBC患者为研究对象,根据不同的术式分为A组及B组,每组各50例患者。A组患者采用TURBT治疗,B组患者采用HOLRBT治疗,比较两组患者的围术期相关指标、术后并发症发生情况、预后情况及血清学指标。结果 B组患者的手术时间、术中出血量、膀胱冲洗时间、术后住院时间及尿管留置时间均少于A组,差异均有统计学意义(P<0.05)。B组患者术后并发症发生率为4.0%(2/50),低于对照组的16.0%(8/50),差异有统计学意义(P<0.05)。两组患者的肿瘤复发率及1年无复发存活率比较,差异无统计学意义(P>0.05)。术后3 d,B组患者血清多肽生长因子、肿瘤特异性生长因子水平低于A组,且血浆纤维蛋白原水平高于A组,差异均有统计学意义(P<0.05)。结论与TURBT比较,采用HOLRBT方法治疗NMIBC可显著降低患者手术创伤,安全有效,并可加快患者的康复速度。

Objective To investigate the clinical effects, serological indicators and prognosis of transurethral resection of bladder tumor（TURBT） and transurethral hohnium laser resection（HOLRBT） for nonmuscle invasive bladder cancer（ NMIBC ） patients. Methods A retrospective study was performed on 100 cases of NMIBC patients. According to the different surgical methods,patients were divided into A group with 50 cases and B group with 50 cases, patients in A group were given TURBT, and patients in B group were given HOLRBT, then the two groups were compared in terms of the clinical effects, serological indicators and prognosis. Results The B group patients＇operation time, the amount of bleeding, bladder flushing time, length of stay, catheter retention time were better than the A group （ P 〈 0.05 ） ; Group B patients the incidence of postoperative complications was 4. 0% （ 2/50）, lower than the control group 16.0% （ 8/50 ）, the difference was statistically significant （ P 〈 0.05 ）. Two groups of patients with tumor recurrence rate and 1 year relapse-free survival rates, there was no statistically significant difference （ P 〉 0.05 ）. Postoperative 3 d, group B patients hepatocyte growth factor, tumor supplied group factors lower than that of group A, and plasma fibrinogen higher than that of group A, differences were statistically significant （P 〈 0.05 ）. Conclusion Compared with TURBT, NMIBC patients with HOLRBT treatment under the condition of the long-term prognosis is consistent, can significantly reduce the surgical trauma, accelerate its recovery rate,is worth promoting in the clinical practice.