腹腔镜根治性膀胱全切术在治疗膀胱癌患者中的应用及其对患者各项手术指标的影响  

Application of laparoscopic radical cystectomy in the treatment of bladder cancer and its influence on the operation indexes of patients

作　　者：王鹏桥[1] 张琴[2] 郑人源[2] 向宸辉[1] WANG Peng-qiao;ZHANG Qin;ZHENG Ren-yuan;XIANG Zheng-hui(Department of Urology,First Affiliated Hospital of Chengdu Medical College;Chengdu Medical College,Chengdu 610500,Sichuan,China)

机构地区：[1]成都医学院第一附属医院泌尿外科 [2]成都医学院,四川成都610500

出　　处：《川北医学院学报》2021年第1期64-67,共4页Journal of North Sichuan Medical College

基　　金：四川省教育厅科研基金(No.14ZB0243)。

摘　　要：目的:探讨腹腔镜根治性膀胱全切术在治疗膀胱癌患者中的应用及其对患者各项手术指标的影响。方法:选取98例膀胱癌患者为研究对象,按入院先后顺序编号,并将奇数号纳入观察组,偶数号纳入对照组,每组各49例。对照组采取开放性手术治疗,观察组给予腹腔镜根治性膀胱全切术治疗。比较两组患者手术效果、术中及术后相关指标、并发症发生率、术后应激指标水平及术后随访2年后患者的局部复发率、远端转移率和死亡率。结果:两组患者的淋巴结清扫个数、阳性淋巴结个数比较,差异无统计学意义(P>0.05);观察组手术时间、术中出血量、肠道功能恢复时间、术后下床活动时间、住院时间均低于对照组(P<0.05);观察组患者并发症发生率低于对照组(P<0.05);术后观察组患者应激指标皮质醇(Cor)、肾上腺素(AD)水平低于对照组,超氧化物歧化酶(SOD)水平高于对照组(P<0.05)。随访2年显示,观察组局部复发率、远端转移率和死亡率均低于对照组(P<0.05)。结论:腹腔镜根治性膀胱全切术在治疗膀胱癌患者中的应用效果良好,能够降低手术对患者的创伤,促进术后快速康复,患者应激反应较轻,且患者的远期疗效更好,手术安全性高,值得临床推广应用。Objective:To study the application of laparoscopic radical cystectomy in the treatment of bladder cancer and its effect on various surgical indicators.Methods:98 patients with bladder cancer admitted were randomly divided into observation group and control group,49 cases in each.The control group received open surgery,while the observation group received laparoscopic radical cystectomy.The operative effect,intraoperative and postoperative related indicators,incidence of complications and levels of post-operative stress indicators were compared and analyzed between the two groups.Two groups of patients were followed up for 2 years.The local recurrence rate,distal metastasis rate and mortality rate of the two groups were compared.Results:There was no significant difference in the number of lymph nodes dissected and positive lymph nodes between the two groups(P>0.05).The operation time,bleeding volume,intestinal function recovery time,time of getting out of bed and hospital stay in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).After operation,the levels of cortisol(COR)and adrenaline(AD)in the observation group were lower than those in the control group,while the level of superoxide dismutase(SOD)in the observation group was higher than that in the control group(P<0.05).Follow-up for two years showed that the local recurrence rate,distal metastasis rate and mortality in the observation group were lower than those in the control group(P<0.05).Conclusion:Laparoscopic radical cystectomy is effective in the treatment of bladder cancer patients.It can reduce the trauma of patients and promote rapid recovery after operation.The stress response of patients is mild,and the long-term effect of patients is better,the safety of operation is high.It is worthy of clinical recommendation.

关 键 词：膀胱癌 腹腔镜 根治术 手术效果 应激反应 并发症发生率 

分 类 号：R737.14[医药卫生—肿瘤]