非肌层浸润性膀胱癌患者二次经尿道膀胱肿瘤钬激光切除术的临床意义

Clinical Significance of Second Transurethral Holmium Laser Resection of Non Muscle Invasive Bladder Cancer

目的探讨非肌层浸润性膀胱癌(NMIBC)患者二次经尿道膀胱肿瘤钬激光切除术治疗的临床效果。方法选取82例NMIBC患者,按随机数字表法分为2组,各41例。对照组予以经尿道膀胱肿瘤电切术(TURBT)治疗,观察组予以经尿道膀胱肿瘤钬激光切除术治疗。比较2组手术情况、炎症因子水平、氧化应激因子、病理诊断准确率及并发症。结果观察组肉眼血尿时间[(1.29±0.23)d]、尿管留置时间[(2.35±0.27)d]、术后膀胱冲洗时间[(1.42±0.25)d]较对照组短,有统计学差异(P<0.05)。观察组治疗后白介素-6(IL-6)[(67.25±6.19)pg/mL]、C反应蛋白(CRP)[(17.25±2.19)mg/L]及肿瘤坏死因子-α(TNF-α)[(40.39±4.28)pg/mL]水平较对照组低,有统计学差异(P<0.05)。观察组治疗后丙二醛(MDA)[(5.74±1.05)mmol/L]水平低于对照组,超氧化物岐化酶(SOD)[(105.96±9.58)μmol/L]及谷胱甘肽过氧化物酶(GSH-Px)[(70.14±6.23)pg/mL]水平较对照组高,有统计学差异(P<0.05)。观察组病理诊断准确率[90.24%(37/41)]高于对照组,并发症发生率[4.88%(2/41)]低于对照组,有统计学差异(P<0.05)。结论二次经尿道膀胱肿瘤钬激光切除术治疗NMIBC较TURBT效果更佳,能够减轻手术创伤,缩短肉眼血尿、尿管留置时间,减轻炎症反应及氧化应激反应,且切除标本更符合病理分期要求,安全可靠。

Objective To investigate the clinical effect of second transurethral holmium laser resection of non muscle invasive bladder cancer(NMIBC).Methods 82 patients with NMIBC were selected and divided into 2 groups according to the random number table,41 patients in each group.The control group was treated with transurethral resection of bladder tumor(TURBT),and the observation group was treated with transurethral resection of bladder tumor with holmium laser.The surgical condition,inflammatory factor level,oxidative stress factor,accuracy of pathological diagnosis and complications were compared between the 2 groups.Results The time of gross hematuria[(1.29±0.23)d],indwelling catheter[(2.35±0.27)d],and postoperative bladder flushing[(1.42±0.25)d]in the observation group were shorter than those in the control group,with statistical differences(P<0.05);Interleukin-6(IL-6)[(67.25±6.19)pg/mL],C-reactive protein(CRP)[(17.25±2.19)mg/L]and tumor necrosis factor in the observation group after treatment-α(TNF-α)[(40.39±4.28)pg/ml]level was lower than that of the control group(P<0.05);After treatment,the level of malondialdehyde(MDA)[(5.74±1.05)mmol/L]in the observation group was lower than that in the control group,and the level of superoxide dismutase(SOD)[(105.96±9.58)μThe levels of mol/L]and glutathione peroxidase(GSH Px)[(70.14±6.23)pg/ml]were higher than those in the control group(P<0.05);The accuracy rate of pathological diagnosis[90.24%(37/41)]in the observation group was higher than that in the control group,and the complication rate[4.88%(2/41)]was lower than that in the control group,with statistical difference(P<0.05).Conclusion The second transurethral resection of bladder tumor with holmium laser is more effective in the treatment of NMIBC,which can reduce the surgical trauma,shorten the time of gross hematuria and catheter retention,reduce the inflammatory reaction and oxidative stress reaction,and the resected specimen is more consistent with the pathological staging requirements,safe and reliable.