NMIBC患者行电切术和钬激光术的疗效比较

Comparison of curative effects of resection and holmium laser surgery in NMIBC patients

目的观察非肌层浸润性膀胱癌(NMIBC)患者行电切术和钬激光术的疗效。方法选取我院2016年1月至2017年1月行NMIBC切除术的60例患者,其中30例行经尿道膀胱肿瘤电切术(TURBT)设为TURBT组,30例患者行经尿道钬激光切除肿瘤手术设为钬激光组。比较两组患者的手术时间、术中出血量、术后尿管留置时间、住院时间、并发症发生率,1年后肿瘤复发率及炎症因子水平。结果钬激光组患者手术时间、术后尿管留置时间及住院时间均短于TURBT组(P<0.05),术中出血量少于TURBT组(P<0.05),钬激光组并发症总发生率和1年后肿瘤复发率均明显低于TURBT组(P<0.05);术后24 h,两组CRP、WBC水平均显著升高,但钬激光组显著低于TURBT组(P<0.05)。结论经尿道钬激光切除肿瘤手术后恢复情况、并发症发生率、肿瘤复发情况和炎症因子水平均优于TURBT,值得临床上应用。

Objective To observe the curative effect of resection a nd holmium laser surgery in non-muscle-invasive bladder cancer（NMIBC） patients. Methods Sixty cases of patients undergoing NMIBC resection from January 2016 to January 2017 were selected. Thirty patients treated with transurethral resection of bladder tumor（TURBT） were set as TURBT group, and 30 patients treated with transurethral holmium laser resection of bladder tumor were set as homium laser group. The operative time, intraoperative blood loss, postoperative catheterization time, hospital stays, incidence of complications, tumor recurrence rate after 1 year and inflammatory factor levels in the two groups were compared. Results The operative time, postoperative catheterization time, hospital stay in the holmium laser group were shorter than those in the TURBT group（P〈0.05）, the intraoperative blood loss was less than that in the TURBT group（P〈0.05）, and the total incidence of complications and tumor recurrence rate after 1 year were significantly lower than those in the TURBT group（P〈0.05）. After 24 hours operation, the levels of CRP and WBC significantly increased in the two groups, but those in the holmium laser group were significantly lower than the TURBT group（P 0.05）. Conclusion The postoperative recovery,incidence of complications, tumor recurrence rate and inflammatory factor levels of transurethral holmium laser resection of bladder tumor is superior to TURBT, which is worthy of clinical application.