经尿道针状电极膀胱肿瘤剜除术治疗非浸润性膀胱癌的疗效分析

Clinical efficacy of en bloc transurethral resection of bladder tumor for non-muscle invasive bladder cancer

目的:研究经尿道膀胱肿瘤剜除术的安全性及有效性,并分析影响非浸润性膀胱癌复发的因素。方法:选取70例非浸润性膀胱癌患者,随机分为经尿道膀胱肿瘤切除术组(transurethral resection of bladder tumor,TURBT)和经尿道针状电极膀胱肿瘤整块剜除术组(en bloc resection of bladder tumor,ERBT),每组35例患者,比较两组患者的手术时间、术后住院时间、发生闭孔反射情况、膀胱冲洗时间、留置导尿管时间及术后复发情况,并对所得数据进行统计学分析。结果:两组手术时间、术后住院时间及发生闭孔反射情况比较存在统计学差异,在术后患者膀胱冲洗的时间及留置导尿的时间方面无统计学差异。通过分析影响术后复发的因素,我们发现肿瘤大小、年龄及肿瘤病理分级比较具有统计学意义,而手术方式、手术时间、膀胱冲洗时间、留置尿管时间及年龄比较无统计学意义。通过对影响复发的多因素logistic回归分析,结果显示年龄和病理组织分级是影响患者复发的因素。结论:ERBT是一种治疗非浸润性膀胱癌安全有效的术式,值得临床推广。

Objective:To evaluate the safety and efficacy of en bloc resection of bladder tumor,and to analyze the factors influencing the recurrence of non-invasive bladder cancer.Methods:70 patients with non-muscle invasive bladder cancer were divided into 35 patients who were treated with en bloc resection of bladder tumor(ERBT)and 35 patients who were treated with transurethral resection of bladder tumor(TURBT).The operation time,postoperative hospitalization time,obturator reflex,bladder irrigation time,indwelling catheter time and postoperative recurrence were compared between the two groups,and the data were statistically analyzed.Results:There were statistical differences in operation time,postoperative hospital time and obturator reflex between the two groups,and there was no significant difference in bladder irrigation time and indwelling catheter time.By analyzing the factors of postoperative recurrence,we found that the size,age and pathological grade of the tumor were statistically significant,but the operation methods,operation time,bladder irrigation time,indwelling time and age were not statistically significant.The results of multiple logistic regression analysis showed that age and pathological grade were the factors influencing the recurrence.Conclusion:En bloc resection of bladder tumor is a safe and effective method for the treatment of non-invasive bladder cancer.