超选择动脉栓塞联合经尿道电切术治疗高危膀胱癌的临床研究  

Clinical Study on Superselective Arterial Embolization Combined with Transurethral Resection in the Treatment of High-Risk Bladder Cancer

作　　者：李文钊[1] 刘明建[1] 张启飞[1] 梁威飘 吴保忠[1] 杨帝宽 张伟健[1] LI Wenzhao;LIU Mingjian;ZHANG Qifei;LIANG Weipiao;WU Baozhong;YANG Dikuan;ZHANG Weijian(Zhaoqing Second People's Hospital,Zhaoqing 526000,China)

机构地区：[1]肇庆市第二人民医院

出　　处：《临床医学工程》2019年第11期1507-1508,共2页Clinical Medicine & Engineering

基　　金：2016年肇庆市科技创新指导类项目(项目编号：201624030708)

摘　　要：目的探讨超选择动脉栓塞联合经尿道电切术治疗高危膀胱癌的临床效果。方法选择47例高危膀胱癌患者,均行超选择动脉栓塞联合经尿道电切术治疗,统计术中出血量、术后出血量、膀胱冲洗时间、住院时间、临床症状改善情况,手术前后的生活质量、血常规、肾功能,术后并发症情况以及肿瘤复发情况。结果行超选择动脉栓塞联合经尿道电切术治疗后,47例高危膀胱癌患者的术中出血量为(36.74±4.13) m L,术后出血量为(23.17±3.46) m L,膀胱冲洗时间为(19.24±3.37) min,住院时间为(7.85±1.43) d;患者完成栓塞治疗后,血尿症状明显改善,尿急、尿频等症状有所缓解。患者完成经尿道电切手术治疗后1个月,血尿、尿急、尿频等症状基本消失。47例患者术后生活质量评分明显高于术前(P <0.05),术后HGB水平及肾功能未见明显下降(P>0.05)。47例患者术后仅有2例术后出现轻微恶心、呕吐,术后3个月肿瘤复发率为2.13%。结论超选择动脉栓塞联合经尿道电切术治疗高危膀胱癌患者具有较好的临床效果,可避免患者肿瘤复发,减少患者术中、术后出血量,降低患者术后并发症发生率,利于患者术后尽快恢复,是一种安全、有效的治疗方法。Objective To explore the clinical effect of superselective arterial embolization combined with transurethral resection in the treatment of high-risk bladder cancer. Methods 47 patients with high-risk bladder cancer undergoing superselective arterial embolization combined with transurethral resection. The intraoperative blood loss, postoperative blood loss, bladder irrigation time, hospitalization time,improvement of clinical symptoms, the quality of life, blood routine and renal function before and after operation, postoperative complications and tumor recurrence were counted. Results After superselective arterial embolization combined with transurethral resection,the intraoperative blood loss was(36.74 ± 4.13) m L, the postoperative blood loss was(23.17 ± 3.46) m L, the bladder irrigation time was(19.24 ± 3.37) min, and the hospitalization time was(7.85 ± 1.43) d in 47 patients with high-risk bladder cancer. After embolization, the hematuria significantly improved, and the urinary frequency and urgency alleviated. 1 month after transurethral resection, the hematuria,urinary frequency and urgency almost disappeared. The postoperative quality of life score in 47 patients was significantly higher than that before operation(P <0.05), but the hemoglobin level and renal function did not decrease significantly after operation(P >0.05). Only 2 cases had slightly nausea and vomiting, and the tumor recurrence rate 3 months after operation was 2.13%. Conclusions Superselective arterial embolization combined with transurethral resection in the treatment of high-risk bladder cancer has better clinical effect, can avoid tumor recurrence, reduce the intraoperative and postoperative blood loss, and postoperative incidence of complications, and help patients recover as soon as possible, which is a safe and effective treatment method.

关 键 词：高危膀胱癌 超选择动脉栓塞 经尿道电切术 治疗效果 

分 类 号：R737.14[医药卫生—肿瘤]