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河北医学  2018, Vol. 24 Issue (9): 1544-1547    DOI: 10.3969/j.issn.1006-6233.2018.09.036
  临床研究 本期目录 | 过刊浏览 | 高级检索 |
尿道膀胱肿瘤电切术与绿激光治疗膀胱尿路上皮癌的疗效对比
李勇1, 徐志刚1, 程文广2
1.重庆市红十字会医院江北区人民医院泌尿外科, 重庆 400020
2.解放军第四五七医院医务处, 湖北 武汉 430012
Comparison of Transurethral Resection of Bladder Tumor and Green Laser in the treatment of Bladder Urothelial Carcinoma
LI Yong, XU Zhigang, et al
Chongqing Red Cross Hospital People's Hospital of Jiangbei District, Chongqing 400020, China
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摘要 目的: 对比经尿道膀胱肿瘤电切术与选择性绿激光治疗膀胱尿路上皮癌的临床疗效。 方法: 选择78例非肌层浸润性膀胱尿路上皮癌(NMIBC)患者作为研究对象,根据治疗方式的不同分为两组,电切组与激光组,每组39例,电切组患者采用经尿道膀胱肿瘤电切术,激光组患者采用选择性绿激光治疗,对比两组患者术中术后情况以及不良反应发生率,采用Kaplan-Meier存分析对3年内患者无复发生存期、总体生存期进行分析。 结果: 电切组手术时间、输血率以及发生闭孔神经反射、术中穿孔均高于激光组,但差异无统计学意义(P>0.05)。激光组出血量术后冲洗量、低于电切组,导尿管留置时间以及住院时间均短于电切组,差异有统计学意义(P<0.05)。电切组不良反应发生率(35.89%)高于激光组(28.21%),不良反应主要包括尿频、尿急、尿痛、血尿、恶心、呕吐、发热,不同类型对比差异无统计学意义(P>0.05)。电切组3年内生存率(89.74%)低于激光组(94.87%)、复发率(25.64%)高于激光组(10.26%),差异无统计学意义(P>0.05);电切组平均复发时间高于激光组,差异有统计学意义(P<0.05)。两组患者无复发生存曲线以及整体生存曲线对比,差异无统计学意义(χ2=0.629,P=0.428;χ2=0.583,P=0.445)。 结论: 选择性绿激光治疗膀胱尿路上皮癌创伤小、出血量少,临床不良反应少,复发率低,效果优于传统尿道膀胱肿瘤电切术,是治疗膀胱尿路上皮癌有效方法。
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李勇
徐志刚
程文广
关键词 膀胱尿路上皮癌 尿道膀胱肿瘤电切术 选择性绿激光    
AbstractObjective: To compare the clinical efficacy of transurethral resection of bladder tumor and selective green laser in the treatment of bladder urothelial carcinoma. Methods: 78 patients with non invasive invasive bladder urothelial carcinoma (NMIBC) treated in our hospital were selected as the study subjects. They were divided into two groups according to the different treatment methods,electro cutting group and laser group, 39 cases in each group,transurethral resection of bladder tumor was performed in the transurethral resection group,the patients in the laser group were treated with selective green laser.The intraoperative, postoperative and adverse reactions were compared between the two groups; No recurrence, overall survival, and overall survival were analyzed within 3 years using Kaplan-Meier retention analysis. Results: The operation time, blood transfusion rate, obturator nerve reflex and perforation in the operation group were higher than those in the laser group, but the difference was not statistically significant (P>0.05). The amount of bleeding in the laser group and the amount of irrigation after operation were lower than those in the cut group, indwelling time of catheter and the length of hospital stay were shorter than those of electric cutting group, the difference was statistically significant (P<0.05).The incidence of adverse reactions in the electric cutting group (35.89%) was higher than that in the laser group (28.21%),the main adverse reactions include frequent urination, urgency, dysuria, hematuria, nausea, vomiting, fever, there was no significant difference between different types (P>0.05).The survival rate in the 3 year group (89.74%) was lower than that in the laser group (94.87%), the recurrence rate (25.64%) was higher than that of laser group (10.26%), the difference was not statistically significant (P>0.05).The average recurrence time of the electric cutting group was higher than that of the laser group, the difference was statistically significant (P<0.05).There was no significant difference between the two groups in the relapse free survival curve and the overall survival curve(χ2=0.629,P=0.428;χ2=0.58,P=0.445). Conclusion: Selective green laser treatment of bladder urothelial carcinoma is less traumatic, less bleeding, less clinical adverse reaction and low recurrence rate. The effect is better than traditional urethral resection of urinary bladder tumor. It is an effective method for the treatment of bladder urothelial carcinoma.
Key wordsBladder urothelial carcinoma    Transurethral resection of bladder tumor    Selective green laser
    
基金资助:重庆市卫生计生委2014年医学科研计划项目,(编号:20142158)
通讯作者: 程文广   
引用本文:   
李勇, 徐志刚, 程文广. 尿道膀胱肿瘤电切术与绿激光治疗膀胱尿路上皮癌的疗效对比[J]. 河北医学, 2018, 24(9): 1544-1547.
LI Yong, XU Zhigang, et al. Comparison of Transurethral Resection of Bladder Tumor and Green Laser in the treatment of Bladder Urothelial Carcinoma. HeBei Med, 2018, 24(9): 1544-1547.
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