经尿道钬激光膀胱肿瘤切除术治疗膀胱癌患者的疗效及其对炎性因子的影响分析

Efficacy analysis of bladder cancer patients treated with transurethral holmium laser resection of bladder tumor and its effect on nflammatory factor

目的分析经尿道钬激光膀胱肿瘤切除术(HOLRBT)对膀胱癌患者的疗效及相关因子的影响。方法回顾性分析2015年3月至2017年3月在本院接受手术治疗的90例膀胱癌患者的临床资料,根据患者选择手术术式不同分为观察组(HOLRBT治疗,50例)和对照组[经尿道膀胱肿瘤等离子切除术(PKRBT)治疗,40例],比较两组患者的围手术期相关指标(手术时间、平均住院时间、留置尿管时间、膀胱冲洗时间)、并发症发生情况、炎性因子水平[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]的变化以及无复发累积生存率情况。结果观察组患者平均住院时间、留置尿管时间、膀胱冲洗时间明显低于对照组(t=2.731、5.671、3.369,P<0.05),两组患者手术时间比较,差异无统计学意义(t=0.872,P>0.05);术后观察组患者并发症总发生率(2.00%)明显低于对照组(12.50%),差异具有统计学意义(χ2=3.938,P<0.05);两组患者术前炎性因子水平指标变化比较,差异无统计学意义(P>0.05),术后观察组患者的IL-6、TNF-α、PCT水平明显低于对照组,差异均具有统计学意义(t=3.678、3.463、2.110,P<0.05);Kaplan-Meier生存分析曲线发现,观察组24个月无累积复发率与对照组比较,差异无统计学意义(χ2=1.040,P>0.05)。结论 HOLRBT治疗膀胱癌效果显著,患者术后并发症发生率较低,对炎性因子影响较小,手术安全性更高,值得临床推广应用。

Objective To analyze the effect of transurethral holmium laser resection of bladder tumor(HOLRBT)on bladder cancer and its related factors.Methods From March 2015 to March 2017,the clinical data of 90 patients with bladder cancer were retrospectively analyzed,and they were divided into the observation group(HOLRBT)with 50 patients and the control group(plasma kinetic resectionof the prostate,PKRBT)with 40 patients were selected according to the different surgical methods.Results The blood loss,indwelling catheter time and bladder flushing time in the observation group were significantly lower than those in the control group(t=2.731,5.671,3.369,P<0.05),and there was no significant difference in operative time between the two groups(t=0.872,P>0.05).The total incidence of complications in the observation group(2.00%)was significantly lower than that in the control group(12.50%),and the difference was statistically significant=3.938,(P<0.05).There were no significant difference in preoperative inflammatory index between the two groups(P>0.05),while the levels of IL-6,TN F-a,and PCT in the observation group were significantly lower than those in the control group after operation(t=3.678,3.463,2.110,P<0.05).Kaplan-Meier survival analysis curve showed that there was no significant difference in the cumulative recurrence rate between the observation group and the control group at 24 m onths(X^2=1.040,P>0.05).Conclusions Transurethral holmium laser cystectomy for bladder cancer is effective,with low incidence of complications,less influence on inflammatory factors and higher safety.It is worthy of clinical application.