经尿道钬激光切除与电切治疗浅表性膀胱癌的疗效对比

Efficacy comparison of holium laser resection and transurethral resection in the treatment of superficial bladder cancer

目的:评估经尿道钬激光膀胱肿瘤切除术(HOLBT)治疗浅表性膀胱癌的临床疗效,并与经尿道膀胱肿瘤电切术(TURBT)作比较。方法:根据手术方式的不同,将97例浅表性膀胱癌患者分为HOLBT组49例和TURBT组48例。观察两组患者手术情况、手术前后体内炎症因子水平的变化、并发症发生情况以及术后2年的累积复发情况。结果:HOLBT组术中出血量明显少于TURBT组,留置尿管时间及住院时间显著短于TURBT组(P<0.01)。HOLBT组术后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平明显低于TURBT组,IL-10水平明显高于TURBT组,差异有统计学意义(P<0.01)。HOLBT组并发症总发生率为6.12%,2年累积复发率为8.16%;TURBT组并发症总发生率为20.83%,2年累积复发率为22.92%,两组比较差异均有统计学意义(P<0.05)。结论:HOLBT治疗浅表性膀胱癌疗效显著,安全性高,不仅对术后炎症因子水平影响小,且有助于降低术后复发率。

Objective:To compare the efficacy of holium laser resection of bladder tumor(HOLBT)and transurethral resection of bladder tumor(TURBT)in the treatment of superficial bladder cancer.Methods:According to different surgical methods,97patients with superficial bladder cancer were divided into HOLBT group(n=49)and TURBT group(n,=48).The surgical conditions,levels of pre-and postoperative inflammatory factors,complications and postoperative2-year accumulative recurrence rate were all observed in two groups.Results:Compared with TURBT group,intraoperative amount of bleeding decreased obviously,time of indwelling catheter and hospital stays were shorter in HOLBT group(P<0.01).Compared with TURBT group,levels of postoperative interleukin-6(IL-6)and tumor necrosis factor-a(TNF-a)reduced significantly,while that of IL-10increased markedly in HOLBT group(P<0.01).The total incidence of complications and postoperative2-year accumulative recurrence rate were6.12%,8.16%in HOLBT group and20.83%,22.92%in TURBT group,and both significant differences were shown between two groups(P<0.05).Conclusion:HOLBT has significant efficacy and higher safety in the treatment of superficial bladder cancer.It hardly impacts the levels of postoperative inflam-matory factors,and is conductive to decreasing postoperative recurrence rate.