经尿道钬激光切除术治疗非肌层浸润性膀胱肿瘤的疗效分析

Transurethral holmium laser excision for the treatment of non-muscle-invasive bladder tumor

目的观察经尿道钬激光切除术治疗非肌层浸润性膀胱肿瘤的临床效果。方法将2011年8月至2015年11月于我院接受治疗的非肌层浸润性膀胱肿瘤患者150例随机分为对照组(75例)和治疗组(75例),对照组采用经尿道膀胱肿瘤电切术(TURBT)进行治疗,治疗组采用经尿道钬激光膀胱肿瘤切除术(HOLRBT)进行治疗,对比两组患者的术中出血量、手术时间、尿管留置时间、膀胱冲洗时间、住院时间及2年累积复发率。结果两组患者手术时间比较,差异无统计学意义(P>0.05),HOLRBT组患者膀胱冲洗时间、尿管留置时间及住院时间均短于TURBT组,术中出血量少于TURBT组(P均<0.05);HOLRBT组患者并发症发生例数低于TURBT组(P<0.05);HOLRBT组2年累积复发率低于TURBT组,差异有统计学意义(P=0.034)。结论HOLRBT治疗非肌层浸润性膀胱肿瘤,能有效控制病情,明显改善患者的生活质量,值得推广。

Objective To evaluate the clinical effect of transurethral holmium laser resection for non-muscle-invasive bladder cancer. Methods From August 2011 to November 2015,150 patients with superficial bladder tumor treated in our hospital were randomly divided into treatment group(75 patients)and control group(75 patients).The treatment group was treated with HOLRBT.In the control group,TURBT was performed.The operative time,intraoperative blood loss,bladder irrigation time,catheter retention time,hospital stay and 2-year cumulative recurrence rate were compared between the two groups. Results There was no significant difference in the operation time between the two groups(P>0.05).The blood loss of HOLRBT group was less than that of TURBT group,and the time of urinary bladder irrigation and the hospital stay were also shorter than those of TURBT group(P<0.05).The overall complication rate in the HOLRBT group was lower than that in the TURBT group(P>0.05).The 2-year cumulative recurrence rate in the HOLRBT group was lower than that in the TURBT group(P<0.05).The 2-year cumulative recurrence rate of the two groups was statistically significant(P<0.05). Conclusions HOLRBT is an effective method for the treatment of patients with non-muscle-invasive bladder tumor,which can effectively control the condition and improve the quality of life of the patients.