经尿道铥激光联合盐酸吡柔比星膀胱灌注治疗高龄腺性膀胱炎的临床研究

Clinical study of transurethral thulium laser combined with intravesical instillation of pirarubicin hydrochloride in the treatment of senile cystitis glandularis

目的探究对高龄腺性膀胱炎患者采用经尿道铥激光联合盐酸吡柔比星膀胱灌注治疗的效果。方法60例高龄腺性膀胱炎患者,随机分为治疗组和对照组,每组30例。治疗组患者采用经尿道铥激光治疗,对照组患者采用经尿道电切术治疗,术后两组患者均采用盐酸吡柔比星灌注治疗。比较两组患者生活质量综合评定量表(GQOLI-74)、下尿路症状(LUST)评分及临床相关指标。结果治疗前,两组患者躯体、心理、社会、物质及LUTS评分比较差异无统计学意义(P>0.05);治疗后,两组患者躯体、心理、社会、物质评分均高于本组治疗前,LUST评分低于本组治疗前,且治疗组患者躯体、心理、社会、物质评分高于对照组,LUST评分低于对照组,差异具有统计学意义(P<0.05)。治疗组患者手术时间(21.05±3.12)min、留置导尿时间(35.48±3.27)h短于对照组的(29.58±3.75)min、(38.59±3.97)h,术中出血量(10.25±2.18)ml少于对照组的(17.69±2.43)ml,手术并发症发生率3.33%、灌注不良反应发生率6.67%均低于对照组的20.00%、26.67%,差异具有统计学意义(P<0.05);两组患者肿瘤复发率比较,差异无统计学意义(P>0.05)。结论经尿道铥激光联合盐酸吡柔比星灌注治疗对于高龄腺性膀胱炎有显著疗效,可明显提升患者生活质量,改善临床症状,且应用安全性较好,值得推荐。

Objective To investigate the effect of transurethral thulium laser combined with intravesical instillation of pirarubicin hydrochloride in the treatment of senile cystitis glandularis.Methods A total of 60 senile patients with cystitis glandularis were randomly divided into treatment group and control group,with 30 cases in each group.The treatment group was treated with transurethral thulium laser,and the control group was treated with transurethral resection.Both groups received pirarubicin hydrochloride for treatment after operation.The generic quality of life inventory-74(GQOLI-74),lower urinary tract symptoms(LUST)score and clinical related indicators between the two groups.Results Before treatment,there was no statistically significant difference in physical,psychological,social,material and LUTS scores between the two groups(P>0.05).After treatment,the physical,psychological,social,material score in two groups was higher than those before treatment,and LUST score was lower than that before treatment.The physical,psychological,social,material score in the treatment group was higher than those in the control group,and LUST score was lower than that in the control group.Their difference was statistically significant(P<0.05).The operation time(21.05±3.12)min and indwelling catheterization time(35.48±3.27)h in the treatment group was shorter than(29.58±3.75)min and(38.59±3.97)h in the control group.The amount of intraoperative hemorrhage(10.25±2.18)ml in the treatment group was less than(17.69±2.43)ml in the control group,and incidence of surgical complications 3.33%and incidence of adverse reactions to instillation 6.67%was lower than 20.00%and 26.67%in the control group.Their difference was statistically significant(P<0.05).There was no statistically significant difference in recurrence rate of tumor between the two groups(P>0.05).Conclusion Transurethral thulium laser combined with pirarubicin hydrochloride perfusion has significant effect on elderly patients with cystitis glandularis.It can significantly improve the quality of life and clinical symptoms of patients.It is safe and worthy of recommendation.