经尿道刀口变向钬激光与直射钬激光膀胱肿瘤整块剜除术治疗非肌层浸润性膀胱肿瘤的疗效比较  

Comparison of efficacy between turning holmium laser en-bloc resection of bladder tumor and holmium laser en-bloc resection of bladder tumor in the treatment of non-muscle-invasive bladder cancer

作　　者：杨华伟[1] 唐汇龙[1] 龙蠡[1] 谢海平[1] 李湘斌[1] YANG Huawei;TANG Huilong;LONG Li;XIE Haiping;LI Xiangbin(Deparment of Urology,First Afilited Hospitl of Hunan University of Tradional Chinese Medicine,Changsha,410007,China)

机构地区：[1]湖南中医药大学第一附属医院泌尿外科,长沙410007

出　　处：《临床泌尿外科杂志》2020年第11期878-881,886,共5页Journal of Clinical Urology

摘　　要：目的:比较经尿道刀口变向钬激光膀胱肿瘤整块剜除术(THOLRBT)与经尿道直射钬激光膀胱肿瘤整块剜除术(HOLRBT)治疗非肌层浸润性膀胱癌(NMIBC)的疗效。方法:回顾性分析60例NMIBC患者,分为THOLRBT组和HOLRBT组,对比分析两组患者的围手术期指标(手术时间、手术前后血红蛋白减少量、膀胱冲洗时间、导尿管留置时间、住院时间、膀胱穿孔发生率)和术后基底部肌层肿瘤病检阳性率、术后1年肿瘤复发率,比较两组指标并进行统计学分析。结果:两组术前一般指标无统计学意义(P>0.05);THOLRBT组手术时间(23.4±7.4) min、术后血红蛋白下降量(9.5±3.2) g/L少于HOLRBT组,THOLRBT组术后基底部肌层肿瘤病检阳性率(3.13%)及术后1年肿瘤复发率(6.25%)低于HOLRBT组,差异有统计学意义(P<0.05);两组均未出现膀胱穿孔并发症。结论:THOLRBT组和HOLRBT组治疗NMIBC床疗效相当,但THOLRBT组更安全,可降低基底部肿瘤漏诊率及术后复发率,临床当中值得推广。Objective: To compare the clinical efficacy between turning holmium laser en-bloc resection of bladder tumor(THOLRBT) and holmium laser en-bloc resection of bladder tumor(HOLRBT) in the treatment of non-muscle-invasive bladder cancer(NMIBC). Method: A retrospective analysis of 60 patients who were diagnosed NMIBC were divided into THOLRBT group and HOLRBT group. The perioperative indexes(operation time, hemoglobin loss, bladder irrigation time, catheter indwelling time, time of hospital stay) and postoperative indexes(positive rate of myometrial tumor in basal part, tumor recurrence rate after 1 year) were recorded and analyzed. Result: There was no significant difference in preoperative factors between the two groups(P>0.05). The operation time(23.4±7.4) min, hemoglobin loss(9.5±3.2) g/L, positive rate of myometrial tumor in basal part(3.13%), tumor recurrence rate after 1 year(6.25%) in THOLRBT were shorter or less than those in HOLRBT(P<0.05). No bladder perforation occurred intraoperatively in both groups. Conclusion: Both THOLRBT and HOLRBT have the same curative effect in the treatment of NMIBC, but the former is more secure. THOLRBT can reduce the missed diagnosis rate of basal tumor and postoperative recurrence rate, so it is worthy of wide application.

关 键 词：经尿道刀口变向钬激光膀胱肿瘤整块剜除术 经尿道直射钬激光膀胱肿瘤整块剜除术 非肌层浸润性膀胱癌 整块剜除 

分 类 号：R737.14[医药卫生—肿瘤]