经尿道电切术和开放手术治疗早期膀胱癌的临床疗效比较

Comparison of clinical efficacy of transurethral resection and open surgery for early bladder cancer

目的探讨经尿道电切术和开放手术治疗早期膀胱癌临床疗效。方法选取2019年6月至2020年6月本院收治的60例早期膀胱癌患者作为研究对象,按照随机数字表法分为观察组和对照组,每组30例。对照组采用常规开放手术治疗,观察组采用经尿道电切术治疗。比较两组术中、术后康复指标(手术时间、术中出血量、术后离床活动时间、导尿管留置时间、住院时间)、手术前后应激及炎症反应指标[皮质醇(Cor)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)]、并发症发生情况及复发率。结果观察组手术时间、术后离床活动时间、导尿管留置时间及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术后,两组Cor、VEGF、TNF-α水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。随访1年,观察组复发率低于对照组,差异有统计学意义(P<0.05)。结论相较于开放手术,经尿道电切术治疗早期的膀胱癌疗效显著,可缩短手术时间,减少出血量,促进术后康复进程,降低机体应激及炎症指标,安全性高,值得临床推广应用。

Objective To investigate the of clinical efficacy of transurethral resection and open surgery for early bladder cancer.Methods 60 patients with early bladder cancer admitted to our hospital from June 2019 to June 2020 were selected as the research subjects,and were divided into observation group and control group according to random number table method,with 30 cases in each group.The control group was treated with conventional open surgery,and the observation group was treated with transurethral resection.The intraoperative and postoperative rehabilitation indexes(operation time,intraoperative blood loss,postoperative time to leave the bed,catheter indenture time,hospital stay),stress and inflammatory response indexes(cortisol[Cor],vascular endothelial growth factor[VEGF],tumor necrosis factor-α[TNF-α])before and after surgery,the occurrence of complications and the recurrence rate of the two groups were compared.Results The operation time,postoperative ambulation time,catheter indignant time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the difference was statistically significant(P<0.05).After surgery,the levels of Cor,VEGF and TNF-αin the two groups were higher than before surgery,and the observation group was lower than control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups.After 1 year of follow-up,the recurrence rate of observation group was lower than control group,and the difference was statistically significant(P<0.05).Conclusion Compared with open surgery,transurethral resection of bladder cancer is effective in the treatment of early bladder cancer,which can shorten the operation time,reduce the amount of bleeding,promote the postoperative rehabilitation process,reduce the body stress and inflammatory indicators,with high safety,and is worthy of clinical application.