腹腔镜与开放手术方式根治性膀胱切除术治疗膀胱癌的效果比较

Comparative the Effect of Laparoscopic and Open Radical Cystectomy for Bladder Cancer

目的比较腹腔镜与开放手术治疗膀胱癌的临床效果。方法将我院2014年1月至2021年10月收治的56例行根治性膀胱切除术治疗的膀胱癌患者作为研究对象,按照随机数字表法将患者分为观察组(31例)和对照组(25例)。对照组行开放式手术治疗,观察组采取腹腔镜手术治疗。比较两组治疗前后的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,并分析两组的简明健康状况量表(SF-36)评分、手术时间、术中出血量、肛门排气时间、盆腔引流管拔除时间、住院时间以及术后输血情况。结果两组患者治疗前的SAS、SDS评分比较,差异无统计学意义(P>0.05);治疗后,观察组SAS、SDS评分低于对照组,差异有统计学意义(P<0.05)。观察组患者各项SF-36评分高于对照组,差异有统计学意义(P<0.05)。观察组手术时间长于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组肛门排气时间、盆腔引流管拔除时间、住院时间短于对照组,差异有统计学意义(P<0.05)。观察组术后输血率(12.90%)低于对照组(44.00%),差异有统计学意义(P<0.05)。观察组术后不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜根治性膀胱切除术应用在膀胱癌中的治疗效果优于开放手术,能有效控制术中出血量,减少术后输血量,且手术创面较小,患者术后恢复速度快。

Objective To compare the clinical application of laparoscopic and open surgery for bladder cancer.Methods The 56 patients with bladder cancer treated by radical cystectomy from January 2014 to October 2021 were included as the research subjects,and the patients were divided into observation group(31 cases)and control group(25 cases)according to the random number table method.The control group underwent open surgery,and the observation group underwent laparoscopic surgery.The SAS and SDS scores before and after treatment of the two groups were compared,and the SF-36 score,operation time,intraoperative blood loss,exhaust time,pelvic drainage removal time,hospital stay and postoperative blood transfusion of the two groups were analyzed.Results The SAS and SDS scores of the two groups before treatment were not significantly different(P>0.05),and after treatment,the SAS and SDS scores in the observation group were lower than those in the control group(P<0.05).The SF-36 scores in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The observation group had a longer operation time than the control group,and the intraoperative blood loss was less than that of the control group,and the difference was statistically significant(P<0.05).The observation group had a statistically significant difference in exhaust time,pelvic drainage removal time,and hospital stay shorter than that in the control group(P<0.05).The postoperative blood transfusion rate in the observation group(12.90%)was lower than that in the control group(44.00%),and the difference was statistically significant(P<0.05).The incidence of postoperative adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment effect of laparoscopic radical cystectomy in bladder cancer is better than that of open surgery,which can effectively control intraoperative blood loss,reduce the amount of postoperative blood transfusion,and the surgical wound is small,and the postoperative recovery speed of patients is fast.