1470nm半导体激光局部切除治疗老年高危膀胱癌的临床价值探讨  

Clinical value of 1470nm diode laser local excision in the treatment of elderly patients with high-risk bladder cancer

作　　者：文瀚东[1] 王涛[1] 潘铁军[1] 徐耀鹏[1] 谢汉平 李晓山[1] WEN Han-dong;WANG Tao;PAN Tie-jun;XU Yao-peng;XIE Han-ping;LI Xiao-shan(Department of Urology,Wuhan General Hospital of Guangzhou Military Command,Wuhan 430070,China)

机构地区：[1]广州军区武汉总医院泌尿外科,430070

出　　处：《现代泌尿生殖肿瘤杂志》2018年第1期13-15,共3页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨1 470nm半导体激光局部切除在治疗老年高危膀胱癌中的临床价值。方法回顾性分析2014年3月至2016年3月在我院行1 470nm半导体激光膀胱癌膀胱局部彻底切除的48例老年高危膀胱癌患者的临床资料,患者年龄75.3~92.6岁,平均82.5岁;术后病理证实18例为肌层浸润性膀胱癌,30例为非肌层浸润性高级别尿路上皮膀胱癌。结果 48例患者均顺利完成手术,平均手术时间(46.3±9.6)min,术中出血(13.6±2.8)ml,术后膀胱冲洗(2.6±0.5)d,留置尿管(7.2±1.5)d,1例发生灌注液外渗,经穿刺引流治愈。随访12~36个月,8例影像学检查复发,2例出现明显肉眼血尿行介入止血治疗。结论采用1 470nm半导体激光局部彻底切除治疗老年高危膀胱癌安全,能有效控瘤、延缓疾病进展、降低肿瘤出血及相关并发症,改善老年患者生活质量。Objective To evaluate the safety and efficacy of 1 470 nm diode laser local excision in the treatment of elderly patients with high-risk bladder cancer. Methods We retrospectively reviewed the clinical data of 48 elderly patients with high-risk bladder cancer,who were treated by 1 470 nm diode laser local excision in our hospital from Mar.2014 to Mar.2016.Eighteen cases were diagnosed as muscle invasive bladder cancer and 30 cases were T 1 high grade urothelial carcinoma by postoperative pathology. Results All operations were completed successfully.The average operating time was(46.3±9.6)min,and hemorrhage volume during surgery was(13.6±2.8)ml.The average bladder irrigation time and indwelling catheterization time was(2.6±0.5)d,(7.2±1.5)d,respectively.During the follow-up period of 12-36 months postoperatively,eight cases were detected recurrence by image and two cases were treated by artery embolization because of hematuria. Conclusions For the elderly patients with high-risk bladder cancer,1 470 nm diode laser enucleation is a safe and effective operation method.It can effectively control the tumor,delay the progression of the disease,reduce tumor bleeding and related complications,improve the quality of life of the elderly patients.

关 键 词：高危膀胱癌 老年 1 470 nm激光 

分 类 号：R737.14[医药卫生—肿瘤]