经尿道膀胱肿瘤整块切除术治疗非肌层浸润性膀胱癌的疗效分析  

Clinical efficacy of en-bloc transurethral resection of bladder tumor for nonmuscle invasive bladder cancer

作　　者：李昱亮[1] 庞建[1] 魏琪波 LI Yuliang;PANG Jian#;WEI Qibo(Department of Urology, Chengdu Sixth People’s Hospital, Chengdu 610051, Sichuan, China)

机构地区：[1]成都市第六人民医院泌尿外科

出　　处：《癌症进展》2019年第11期1296-1298,共3页Oncology Progress

摘　　要：目的探讨经尿道膀胱肿瘤整块切除术治疗非肌层浸润性膀胱癌的疗效。方法采用随机数字表法将98例非肌层浸润性膀胱癌患者分为观察组和对照组,每组49例,观察组患者接受经尿道膀胱肿瘤整块切除术,对照组患者接受经尿道膀胱肿瘤电切术(TURBT)。比较两组患者的围手术期相关指标(手术时间、住院时间、术中出血量、留置导尿管时间、膀胱冲洗时间),术前及术后3个月的血清血管内皮生长因子(VEGF)、重组人Dickkopf相关蛋白1(DKK1)、人类软骨糖蛋白-39(YKL40)水平及手术相关并发症的发生率。结果观察组患者的手术时间、住院时间、留置导尿管时间、膀胱冲洗时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。术前,两组患者的血清VEGF、DKK1、YKL40水平比较,差异均无统计学意义(P﹥0.05)。术后3个月,两组患者的血清VEGF、DKK1、YKL40水平均较本组术前降低(P﹤0.05);术后3个月,两组患者的血清VEGF、DKK1、YKL40水平比较,差异均无统计学意义(P﹥0.05)。观察组患者的并发症总发生率为4.08%,低于对照组的16.33%,差异有统计学意义(P﹤0.05)。结论经尿道膀胱肿瘤整块切除术治疗非肌层浸润性膀胱癌的效果与TURBT相当,但创伤更小、术后恢复更快、并发症更少。Objective To evaluate the efficacy of en-bloc transurethral resection of bladder tumor(TURBT)for nonmuscle invasive bladder cancer(NMIBC).Method A total of 98 patients with NMIBC were divided into observation group and control group with 49 cases in each group by using a random number table.En-bloc TURBT was performed on patients in observation group and TURBT was performed on patients in control group.The perioperative indicators including the operation time,hospitalization time,intraoperative blood loss,indwelling catheter time,bladder irrigation time were compared between the two groups.The levels of serum metrics including vascular endothelial growth factor(VEGF),recombinant human Dickkopf-related protein 1(DKK1)and human cartilage glycoprotein-39(HCgp-39/YKL40)before surgery and 3 months after surgery,and the incidence of surgery related complications were compared between the two groups.Result The operation time,hospitalization time,indwelling catheter time and bladder irrigation time were shorter,and intraoperative bleeding loss was less in observation group than those of the control group,the differences were statistically significant(P<0.01).Before operation,the levels of serum VEGF,DKK1 and YKL40 of patients in the two groups shows no significant difference(P>0.05).At 3 months after operation,the serum VEGF,DKK1 and YKL40 levels in both groups were significant lower than those before operation(P<0.05),while the VEGF,DKK1 and YKL40 levels between the two groups showed no significant difference(P>0.05).The complication rate in the observation group was 4.08%,which was significantly lower than that of 16.33%in the control group(P<0.05).Conclusion En-bloc TURBT is as effective as TURBT in terms of the treatment of NMIBC,and this method of surgery is associated with less trauma,faster recovery time and fewer complications.

关 键 词：经尿道膀胱肿瘤整块切除术 经尿道膀胱肿瘤电切术 非肌层浸润性膀胱癌 并发症 

分 类 号：R737.14[医药卫生—肿瘤]