经尿道钬激光切除术治疗非肌层浸润性膀胱癌患者的安全性及预后观察

Safety and Prognosis of Transurethral Holmium Laser Resection for Non-muscular Invasive Bladder Cancer

目的:探讨经尿道钬激光切除术(HOLBT)在非肌层浸润性膀胱癌(NMIBC)患者中的应用效果。方法:选取笔者所在医院2017年4月-2018年7月收治的NMIBC患者76例,依照治疗方案不同分为两组,各38例,经尿道双极等离子电切术(TUPKRP)组采用TUPKRP术,HOLBT组采用HOLBT。比较两组手术时间、尿管留置时间、住院时间、术后并发症发生率,术后1年肿瘤预后标志物(Ki-67蛋白、P53蛋白)表达情况,术前、术后1年生活质量核心量表(QLQ-C30)评分。结果:HOLBT组尿管留置时间、手术时间、住院时间均短于TUPKRP组,差异均有统计学意义(P<0.05);HOLBT组术后膀胱穿孔、闭孔神经反射并发症发生率(0、0)均低于TUPKRP组(15.79%、23.68%),HOLBT组术后1年Ki-67蛋白、P53蛋白阴性率(81.08%、83.78%)均高于TUPKRP组(54.05%、56.76%),差异均有统计学意义(P<0.05);HOLBT组术后1年QLQ-C30评分低于TUPKRP组,差异有统计学意义(P<0.05)。结论:HOLBT术治疗NMIBC患者,可缩短手术时间,促进恢复,降低术后并发症发生率,改善预后,提高生活质量。

Objective:To investigate the effect of transurethral holmium laser resection(HOLBT)in patients with non-muscular invasive bladder cancer(NMIBC).Method:A total of 76 NMIBC patients in our hospital from April 2017 to July 2018 were selected,according to different treatment regiments,the patients were divided into two groups,38 cases each.TUPKRP was used in the transurethral bipolar plasma electrotomy(TUPKRP)group,and HOLBT was used in the HOLBT group.The operative time,urinary indwelling time,length of hospital stay,incidence of postoperative complications,expression of tumor prognostic markers(Ki-67 protein and P53 protein)at 1 year after surgery,and QLQ-C30 scores before and 1 year after surgery were compared between the two groups.Result:The catheter indwelling time,operation time and hospital stay time in the HOLBT group were shorter than those in the TUPKRP group,the differences were statistically significant(P<0.05).The incidence of postoperative bladder perforation and obturator nerve reflex complications in the HOLBT group(0,0)were lower than those in TUPKRP group(15.79%,23.68%),and the negative rates of Ki-67 protein and P53 protein in the HOLBT group(81.08%,83.78%)were higher than those in the TUPKRP group(54.05%,56.76%)1 year after surgery,the differences were statistically significant(P<0.05).The QLQ-C30 score in the HOLBT group 1 year after operation was lower than that in the TUPKRP group,the difference was statistically significant(P<0.05).Conclusion:HOLBT for NMIBC patients can shorten the operation time,promote the recovery,reduce the incidence of postoperative complications,improve the prognosis and improve the quality of life.