经尿道膀胱肿瘤切除术联合辅助动脉化疗对膀胱癌患者术后控尿、性能力及肿瘤控制效果的影响

Effects of transurethral resection of bladder tumor combined with adjuvant arterial chemotherapy on postoperative urinary continence,sexuality and tumor control effects in patients with bladder cancer

目的:探讨经尿道膀胱肿瘤切除术(transurethral resection of bladder tumor,TURBT)联合辅助动脉化疗对膀胱癌患者术后控尿、性能力及肿瘤控制效果的影响。方法:选取我院2013年5月至2015年5月收治的92例拟行TURBT术治疗的膀胱癌患者为研究对象,随机分为观察组(46例)和对照组(46例),对照组行TURBT术+术后灌注化疗,观察组行术前动脉化疗+TURBT术+术后灌注化疗,比较两组患者围术期情况和术后不同时间控尿率、勃起功能国际问卷(IIEF-5)评分、复发率、总体生存率(OS)生命质量综合评定问卷(GQOLI-74)评分。结果:观察组术中出血量、手术时间、尿管留置时间和住院天数均明显少于对照组(P<0.05);两组间术后3个月IIEF-5评分无显著差异(P>0.05),观察组术后其他时间点IIEF-5评分和各时间点控尿率均明显高于对照组(P<0.05);两组术后6、12、24个月死亡率比较,无显著差异(P>0.05);观察组术后6、12、24个月躯体功能、社会功能、物质生活、心理功能评分均显著高于对照组(P<0.05)。结论:TURBT术联合辅助动脉化疗可有效控制膀胱癌,提高躯体、社会、心理功能等相关生命质量。

Objective:To explore the effects of transurethral resection of bladder tumor(TURBT)combined with adjuvant arterial chemotherapy on postoperative urinary continence,sexuality and tumor control effects in patients with bladder cancer.Methods:92 cases of patients with bladder cancer treated with TURBT in our hospital from May 2013 to May 2015 were selected for the study and randomly divided into observation group(n=46)and control group(n=46).Control group was given TURBT+postoperative infusion chemotherapy,and observation group was given preoperative arterial chemotherapy+TURBT surgery+postoperative infusion chemotherapy.The perioperative situation and postoperative urinary continence rate at different times,international index of erectile function questionnaire(IIEF-5)score,recurrence rate,overall survival rate(OS)and general quality of life questionnaire(GQOLI-74)score were compared between the two groups.Results:The intraoperative blood loss,operative time,catheter indwelling time and hospital stay in observation group were significantly less than those in control group(P<0.05).There was no significant difference in the IIEF-5 score at 3 months after operation between the two groups(P>0.05),and the IIEF-5 score and urinary continence rate at other time points after operation were significantly higher in observation group than those in control group(P<0.05).There was no significant difference in the mortality rate between the two groups at 6,12 and 24 months after operation(P>0.05).The scores of physical function,social function,material life and mental function in observation group at 6,12 and 24 months after operation were significantly higher than those in control group(P<0.05).Conclusion:TURBT combined with adjuvant arterial chemotherapy can effectively control the bladder cancer,and improve physical function,social function and psychological function and other related quality of life.