超选择性膀胱动脉栓塞化疗联合经尿道膀胱肿瘤电切术治疗T2期膀胱癌的临床疗效

Superselective chemoembolization of bladder arteries combined with transurethral resection of bladder tumor in the treatment of T2 stage bladder cancer

目的探讨超选择性膀胱动脉栓塞化疗联合经尿道膀胱肿瘤电切术对T2期膀胱癌患者的治疗效果。方法根据治疗方法的不同将94例T2期膀胱癌患者分为观察组(n=52)和对照组(n=42),观察组患者采用超选择性膀胱动脉栓塞化疗联合经尿道膀胱肿瘤电切术治疗,对照组患者采用根治性膀胱全切术治疗。比较两组患者的围手术期指标(手术时间、术中出血量、术后进食时间、术后下床活动时间及住院时间)、临床疗效及术后1年的生存情况。结果观察组患者的手术时间、术后进食时间和术后下床活动时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01);两组患者的住院时间比较,差异无统计学意义(P﹥0.05)。观察组和对照组患者的总缓解率分别为94.23%(49/52)和97.62%(41/42),差异无统计学意义(P﹥0.05)。随访1年,两组患者的复发率、转移率、无瘤生存率及病死率比较,差异均无统计学意义(P﹥0.05)。结论超选择性膀胱动脉栓塞化疗联合经尿道膀胱肿瘤电切术治疗T2期膀胱癌的手术创伤小,疗效显著,是一种有效的保留膀胱的综合治疗方式。

Objective To study the curative effect of superselective chemoembolization of bladder arteries combined with transurethral resection of bladder tumor(TURBT)in the treatment of T2 stage bladder cancer.Method 94 patients with T2 stage bladder cancer were included and categorized as study group(n=52)or control group(n=42),receiving superselective chemoembolization of bladder arteries+TURBT or radical cystectomy,respectively.The perioperative indicators(operative time,intraoperative blood loss,time to feeding after surgery,postoperative ambulation time and hospitalization time),clinical efficacy,and survival within 1 year after surgery were observed and compared between the two groups.Result The operative time,time to feeding and ambulation after surgery in study group were shorter compared to control group,and the intraoperative blood loss was significantly less than that of the control group(P<0.01);patients in both groups were hospitalized for similar duration after surgery(P>0.05).The overall response rate was 94.23%(49/52)and 97.62%(41/42)in study group and control group,respectively,there was no statistically significant difference noted(P>0.05).All patients were followed up for 1 year,and there were no significant differences regarding the recurrence rate,metastasis rate,tumor-free survival rate,and mortality between the two groups(P>0.05).Conclusion Superelective chemoembolization of bladder arteries combined with TURBT were minimally invasive in the treatment of T2 stage bladder cancer with significant curative effect,and is applicable for bladder preservation.