经尿道膀胱肿瘤电切术治疗浅表性膀胱癌的远期疗效观察

Long term efficacy of transurethral resection of bladder tumor for patients with superficial bladder cancer

目的探讨浅表性膀胱癌患者经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)治疗的临床效果。方法选择2015年5月～2018年8月海南省第二人民医院诊治的74例浅表性膀胱癌患者为研究对象,将其随机分为观察组和对照组,每组37例患者。观察组患者采用TURBT治疗,对照组患者采用膀胱部分切除术治疗,比较两组患者疗效、并发症发生和复发情况等。结果与对照组比较,观察组患者平均手术、膀胱冲洗、导尿留置和住院时间均显著缩短,术中失血量显著减少(t=18.066、13.880、7.623、7.564、12.560,均P<0.05);观察组和对照组患者治疗总有效率分别为83.8%、81.1%,其差异无统计学意义(χ~2=0.093,P>0.05);观察组患者并发症总发生率(8.1%)显著低于对照组患者(32.4%),其差异具有统计学意义(χ~2=6.772,P<0.05);观察组患者术后1、2年复发率(5.4%、16.2%)显著低于对照组患者(24.3%、37.8%),其差异具有统计学意义(χ~2=5.232、4.385,P<0.05);术后2年,观察组患者死亡率(0%)与对照组患者死亡率(8.1%)比较,其差异无统计学意义(χ~2=3.126,P>0.05);观察组患者治疗后SF-36量表总评分显著高于对照组患者,其差异具有统计学意义(t=15.028,P<0.05)。结论采用TURBT治疗浅表性膀胱癌患者,术后并发症发生和复发率均较低,可以使患者生活质量获得明显改善,远期疗效更为理想。

ObjectiveTo evaluate the clinical effect of transurethral resection of bladder tumor (TURBT) for patients with superficial bladder cancer. Methods74 patients with superficial bladder cancer in our hospital from May 2015 to June 2016 were selected and divided into control group and observation group, each of 37 cases. The control group received partial cystectomy while the observation group received TURBT treatment. The efficacy, incidence of complications and recurrence rate were compared between the two groups. ResultsCompared with the control group, the time of operation, bladder irrigation, catheterization retention and hospitalization in the observation group was significantly shorter, and the intraoperative blood loss was significantly less (t=18.066, 13.880, 7.623, 7.564, 12.560, P<0.05). The total effective rate of the observation group and control group was 81.1% and 83.8% respectively, without significant difference between the two groups (χ^2=0.093, P>0.05). The total incidence of complications in the observation group (8.1%) was significantly lower than that in the control group (32.4%), with statistically significant difference (χ^2=6.772, P<0.05). The recurrence rates in the observation group at a year and 2 years postoperative were 5.4% and 16.2% respectively, which were significantly lower than those of the control group of 24.3% and 37.8%, with statistically significant differences (χ^2=5.232, 4.385, P<0.05). The total score of SF-36 scale in the observation group after treatment was significantly higher than that in the control group, with statistically significant difference (t=15.028, P<0.05). ConclusionsTURBT is of remarkable long-term curative effect for patients with superficial bladder cancer, which can significantly improve the quality of life of patients with low incidence of complications and recurrence rate.