经尿道钬激光剜除术对非肌层浸润性膀胱癌术后尿路功能恢复生活质量及预后的影响

doi:10.3969/j.issn.1006-6233.2025.03.016

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1323 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探究经尿道钬激光剜除术(HOLRBT)对非肌层浸润性膀胱癌(NMIBC)术后尿路功能恢复、生活质量及预后的影响。方法: 选取2020年2月至2023年5月本院接受膀胱癌手术的105例患者。根据不同的手术治疗方法,将患者分为对照组[n=50例,接受经尿道膀胱肿瘤电切术(TURBT)]和观察组(n=55例,给与HOLRBT)。比较两组患者围手术期指标、临床疗效、术后膀胱肌层获取率、术后膀胱灌注药物使用、术后并发症(膀胱闭孔反射率、膀胱穿孔率)及生活质量。随访1年,记录两组患者术后复发率和生存率。结果: 与对照组相比,观察组患者手术持续时间、膀胱冲洗时长、留置尿管时长和术中出血量均减少(均P<0.05)。观察组NMIBC患者的临床疗效为89.09%,高于对照组的72.00%(P<0.05)。观察组患者术后膀胱肌层获取率和术后膀胱灌注药物使用较对照组减少(均P<0.05)。观察组患者术后膀胱闭孔反射率为9.09%,膀胱穿孔率为3.64%,低于对照组的26.00%和18.00%(均P<0.05)。观察组生活质量评分(SF-36)较对照组升高(P<0.05)。随访结果显示,观察组患者1年复发率为12.73%(7/55),低于对照组的30.00%(15/50)(χ²=4.718,P=0.030)。Kaplan-Meier生存曲线表明,观察组患者的生存率高于对照组(87.30% vs 74.00%,Log-rank χ²=4.318,P=0.038)。结论: HOLRBT在NMIBC患者中的预后价值显著,能更有效改善患者术后尿路功能,提升生活质量,降低并发症,具有良好的临床应用前景。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	吴德鸣
	焦常宝
	陈健
	项平

关键词 ：经尿道钬激光剜除术, 非肌层浸润性膀胱癌, 尿路功能恢复, 生活质量

Abstract：Objective: To investigate the impact of transurethral holmium laser enucleation of the bladder tumor (HOLRBT) on postoperative urinary function recovery, quality of life, and prognosis in patients with non-muscle-invasive bladder cancer (NMIBC). Methods: A total of 105 patients who underwent bladder cancer surgery at our hospital from February 2020 to May 2023 were enrolled. Based on the surgical approach, patients were divided into a control group (n=50, transurethral resection of bladder tumor [TURBT]) and an observation group (n=55, HOLRBT). Perioperative indicators, clinical efficacy, postoperative bladder muscle layer acquisition rate, postoperative intravesical drug use, complications (bladder obturator reflex rate, bladder perforation rate), and quality of life were compared between the two groups. Patients were followed up for 1 year to record recurrence and survival rates. Results: Compared to the control group, the observation group had shorter surgical duration, bladder irrigation time, and catheter indwelling time, as well as reduced intraoperative blood loss (all P<0.05). The clinical efficacy rate in the observation group was 89.09%, significantly higher than the 72.00% in the control group (P<0.05). The observation group also showed lower postoperative bladder muscle layer acquisition rates and reduced intravesical drug use (both P<0.05). The bladder obturator reflex rate (9.09% vs 26.00%) and bladder perforation rate (3.64% vs 18.00%) were significantly lower in the observation group (all P<0.05). Quality of life scores (SF-36) were higher in the observation group (P<0.05). At 1-year follow-up, the recurrence rate in the observation group was 12.73% (7/55), significantly lower than the 30.00% (15/50) in the control group (χ²=4.718, P=0.030). Kaplan-Meier survival analysis indicated a higher 1-year cumulative survival rate in the observation group (87.30% vs 74.00%, Log-rank χ²=4.318, P=0.038). Conclusion: HOLRBT demonstrates significant prognostic value in NMIBC patients, effectively improving postoperative urinary function, enhancing quality of life, and reducing complications. It holds promising clinical application prospects.

Key words： Transurethral holmium laser enucleation of the bladder tumor Non-muscle-invasive bladder cancer Urinary function recovery Quality of life

基金资助:2020年度安徽省自然科学基金项目,(编号:2008085MH251)

通讯作者: 项平

引用本文:

吴德鸣, 焦常宝, 陈健, 项平. 经尿道钬激光剜除术对非肌层浸润性膀胱癌术后尿路功能恢复生活质量及预后的影响[J]. 河北医学, 2025, 31(3): 439-444.
WU Deming, JIAO Changbao, CHEN Jian, et al. Impact of Transurethral Holmium Laser Enucleation of Bladder Tumor on Postoperative Urinary Function Recovery Quality of Life and Prognosis in Non-Muscle-Invasive Bladder Cancer. HeBei Med, 2025, 31(3): 439-444.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.03.016 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I3/439

[1] 戚宇,王杭,郭剑明,等.膀胱灌注卡介苗治疗中高危非肌层浸润性膀胱癌疗效预测模型的建立[J].复旦学报(医学版),2023,50(6):810-819.
[2] 王玮,李玮,杨俊哲,et al.连续时间随机行走扩散模型联合膀胱影像报告与数据系统诊断膀胱癌肌层浸润状态的研究[J].中华放射学杂志,2024,58(4):394-400.
[3] 唐多才,周术奎,张桂银,等.非肌层浸润性膀胱癌行初次经尿道膀胱肿瘤电切术的术后复发危险因素分析[J].中国癌症杂志,2023,33(5):478-483.
[4] Li C,Gao L,Zhang J,et al.The effect of holmium laser resection versus standard transurethral resection on non-muscle-invasive bladder cancer:a systematic review and meta-analysis[J].Lasers Med Sci,2020,35(5):1025-1034.
[5] Qiuhua Z,Yunxiang L I,Rong H U,et al.Effect of transurethral holmium laser enucleation versus transurethral resection of bladder tumor in treating non-muscle invasive bladder cancer[J].Clin Med Pract,2023,27(6):133-136.
[6] Huawei Y,Huilong T,Li L,et al.Comparison of efficacy between turning holmium laser en-bloc resection of bladder tumor and holmium laser en-bloc resection of bladder tumor in the treatment of non-muscle-invasive bladder cancer[J].Clin Urol,2020,35(11):878-881,886.
[7] Byrne-Kirk M,Mantzioris E,Scannell N,et al.Adherence to a Mediterranean-style diet and severity of menopausal symptoms in perimenopausal and menopausal women from Australia:a cross-sectional analysis[J].Eur Nutr,2024,63(7):2743-2751.
[8] Hashem A,Mosbah A,El-Tabey N A,et al.Holmium laser en-bloc resection versus conventional transurethral resection of bladder tumors for treatment of non-muscle-invasive bladder cancer:a randomized clinical trial[J].Eur Urol Focus,2021,7(5):1035-1043.
[9] Sheybaee Moghaddam F,Dwabe S,Mar N,et al.The role of maximal TURBT in muscle-invasive bladder cancer:balancing benefits in bladder preservation and beyond[J].Cancers,2024,16(19):3361.
[10] Razzaghi M R,Mazloomfard M M,Yavar M,et al.Holmium LASER in comparison with transurethral resection of the bladder tumor for non-muscle invasive bladder cancer:randomized clinical trial with 18-month follow-up[J].Urology Journal,2021,18(4):460-465.
[11] 陆佳伟,缪惠东,沈锋,等.钬激光治疗非肌层浸润性膀胱肿瘤的疗效及安全性[J].国际泌尿系统杂志,2022,42(3):452-456.
[12] 张秋华,李云祥,胡蓉,等.经尿道钬激光剜除术与经尿道膀胱肿瘤电切术对非肌层浸润性膀胱癌的疗效比较[J].实用临床医药杂志,2023,27(6):133-136.