两镜联合采用汽化电切结合钬激光治疗特殊部位的浅表性膀胱肿瘤  

Efficacy on Treatment of Supeficial Bladder Tumor with Vaporization Electroresection and Holmium Laser

作　　者：王庆军[1] 吕民[1] 王海[1] 

机构地区：[1]江苏省新沂市铁路医院泌尿外科,新沂221400

出　　处：《中国医药导刊》2010年第10期1682-1683,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨汽化电切镜联合软质膀胱镜经尿道汽化电切结合钬激光治疗膀胱特殊部位浅表性肿瘤的可行性及临床效果。方法:回顾总结我院2004年5月～2009年6月应用经尿道汽化电切镜联合软质膀胱镜治疗膀胱特殊部位浅表性肿瘤34例临床资料。针对位于膀胱前壁、三角区、膀胱颈部及输尿管开口附近等特殊部位的浅表性肿瘤,先用汽化电切镜汽化电切肿瘤体部,然后插入软质膀胱镜用钬激光烧灼肿瘤蒂部及基底。结果:34例膀胱肿瘤均1次切除,平均手术45分钟,术中无膀胱穿孔、大出血等并发症。术后平均留置导尿管7天,拔除导尿管前行丝裂霉素20mg膀胱灌注一次,出院后,均规范性膀胱灌注化疗。所有病例均进行随访,随访时间最长5年,1年内复发3例(8.8%),3年内复发6例(17.6%),5年内复发8例(23.5%),其中3例为复发2次以上。结论:经尿道汽化电切和钬激光等微创技术治疗浅表性膀胱肿瘤疗效确切,具有创伤小、出血少、并发症少和恢复快等优点,已被临床广泛应用,但是汽化电切镜治疗上存在盲区,对一些特殊位置的肿瘤治疗后,存在复发率高的缺点,我们利用汽化电切镜功率大、切除肿瘤速度快和软质膀胱镜可弯曲性、无盲区的优点,采用两镜联合的方法,对34例特殊部位浅表性膀胱肿瘤进行系统治疗,大大降低了肿瘤复发率,取得了较好地临床效果。Objective：To discuss vaporization electricity cuts the mirror to unite the soft nature cystoscope to vaporize the electricity after the urethra m cut unifies the holmium laser treatment urinary bladder privileged sites shallow table tumor the feasibility and the clinical effect. Methods：The review summarized my courtyard in May,2004-June,2009 to apply after the urethra vaporizes the electricity to cut the mirror to unite the soft nature cystoscope treatment urinary bladder privileged sites shallow table tumor 34 example clinical material. In view of located at the urinary bladder front board,the Delta Region,the urinary bladder pate and the ureter opens the mouth nearby and so on privileged sites shallow table tumor, Uses the vaporization electricity to cut the mirror first to vaporize the electricity to cut the tumor body department,Then inserts the soft nature cystoscope to burn the tumor peduncle department with the holmium laser and the basis.Results：34 example bladder neoplasm even 1 excision,average surgery 45 minutes,in technique non-complications and so on urinary bladder perforation,massive hemorrhage.After the technique,average leaving alone catheter 7 days,Before wiping out the catheter, The good silk crack mildew element 20 mg urinary bladder pours into one time,After the being out of hospital,even regulated urinary bladder irrigation chemotherapy.All cases carry on the revisit, the revisit time are longest for 5 years, l year recurs3 examples （8.8%）,3 years recur 6 examples （17.6%）,5 years recur 8 examples （23.5%）,3examples to recur above 2 times.Conclusion：Vaporizes the electricity after the urethra to cut and so on micro creates the technology with the holmium laser to treat the shallow table bladder neoplasm curative effect to he accurate,has the wound smaU,to bleed few, the complication few and restores and so on merits quickly, Akeady by clinical widespread application,but the vaporization electricity cuts in the mirror treatment to have the blind spot,after some special posi

关 键 词：汽化电切镜 软质膀胱镜 治疗 浅表性膀胱肿瘤 

分 类 号：R737.14[医药卫生—肿瘤] R697.32[医药卫生—临床医学]