经尿道钬激光切除与经尿道双极等离子电切治疗非肌层浸润性膀胱尿路上皮癌的疗效及安全性对比分析  

Comparison of efficacy and safety between transurethral holmium laser resection and transurethral bipolar plasmakinetic resection for non-muscle-invasive urothelial carcinoma of the bladder

作　　者：李伟 刘昊 

机构地区：[1]武汉市红十字会医院(武汉市第十一医院)泌尿外科,430000 [2]武汉市第三医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2017年第3期156-159,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨经尿道钬激光切除与经尿道双极等离子电切治疗非肌层浸润性膀胱尿路上皮癌的疗效及安全性。方法选取2012年5月至2015年12月武汉市红十字会医院收治的86例非肌层浸润性膀胱尿路上皮癌患者作为研究对象,按其治疗方法随机分为A组和B组,每组43例,A组患者在非肌层浸润性膀胱尿路上皮癌的对症基础治疗上经尿道予行钬激光切除术,B组患者在该疾病对症基础治疗上经尿道予行双极等离子电切术。治疗结束后,记录比较两组患者的手术情况、并发症发生情况、住院时间、住院费用及出院随访后的复发情况。结果 A组患者的手术时间及术后冲洗量均明显少于B组(P<0.05);两组患者术后均未出现膀胱穿孔,且在住院时间、导尿管留置时间、住院费用及复发情况的比较上差异均无统计学意义(P>0.05),但A组术中未发生闭孔神经反射,B组闭孔神经反射发生16例(37.21%)(P<0.05)。结论经尿道钬激光切除术可减少非肌层浸润性膀胱尿路上皮癌患者的手术时间及术后冲洗量,降低其闭孔神经反射的发生率,具有止血性好、安全性高等特点,可作为临床上治疗非肌层浸润性膀胱尿路上皮癌的一种首选手术方式。Objective To compare the efficacy and safety between transurethral holmium laser resection and transurethral bipolar plasmakinetic resection for non-muscle-invasive urothelial carcinoma of the bladder. Methods From May 2012 to December 2015 in our hospital,86 cases with nonmuscle-invasive bladder urothelial carcinoma were selected as the research objects,and they were divided into A group and B group（43cases in each group）according to the treatment.Patients of A group were treated by the holmium laser resection based on basic treatment,while patients of B group by transurethral plasmakinetic resection based on basic treatment.The operation condition,complications,hospitalization time,cost of hospitalization and recurrence were recorded and compared between two groups. Results The operative time and amount of postoperative irrigation in the A group were significantly less than those in the B group（P〈0.05）;there was no bladder perforation in both groups and the hospitalization time,catheter retention time,cost of hospitalization and recurrence rate showed no significant difference between two groups（P〉0.05）.There was no obturator nerve reflex in A group,but 16 cases in B group（37.21%）occurred（P〈0.05）. Conclusions Transurethral holmium laser resection offers advantages of good hemostasis and high safety,and it can also reduce the operative time,the amount of postoperative irrigation and the incidence rate of obturator nerve reflex.Thus,it can be used as a preferred mode of operation for the treatment of non-muscle-invasive urothelial bladder cancer.

关 键 词：经尿道钬激光切除术 经尿道双极等离子电切术 非肌层浸润性膀胱尿路上皮癌 

分 类 号：R737.14[医药卫生—肿瘤]