经尿道膀胱肿瘤等离子整块剜除术治疗浅表性膀胱肿瘤的近期疗效  

Effect of transurethral plasma enucleation of superficial bladder tumor

作　　者：开凯[1] 汤海[1] 郭一俊[1] 沈俞 周任远[1] KAI Kai;TANG Hai;GUO Yijun;SHEN Yu;ZHOU Renyuan(Department of Urology Surgery,Shanghai Jing’an District Central Hospital,Shanghai 200040,China)

机构地区：[1]上海市静安区中心医院泌尿外科,上海200040

出　　处：《癌症进展》2021年第23期2443-2445,2449,共4页Oncology Progress

基　　金：上海市静安区医学学科系列项目(2021ZD01)。

摘　　要：目的探讨经尿道膀胱肿瘤等离子整块剜除术治疗浅表性膀胱肿瘤的近期疗效。方法将80例浅表性膀胱肿瘤患者按照治疗方式不同分为电切术组(37例)和等离子整块剜除术组(43例)。比较两组患者手术情况[手术时间、术中出血量、留置导管时间、膀胱穿孔率]、炎症指标[降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[超氧化物歧化酶(SOD)、皮质醇(Cor)]、膀胱功能[国际前列腺症状评分(IPSS)、最大尿流率(Q_(max))]及术后并发症发生情况。结果等离子整块剜除术组患者手术时间明显长于电切术组,术中出血量明显少于电切术组,留置导管时间明显短于电切术组,差异均有统计学意义(P﹤0.01)。术前,两组患者PCT、CRP、TNF-α、SOD、Cor水平比较,差异均无统计学意义(P﹥0.05);术后,两组患者PCT、CRP、TNF-α、SOD水平均明显上升,Cor水平均明显下降,且等离子整块剜除术组患者PCT、CRP、TNF-α、SOD水平均明显低于电切术组,Cor水平明显高于电切术组,差异均有统计学意义(P﹤0.01)。术前、术后,两组患者IPSS评分、Q_(max)水平比较,差异均无统计学意义(P﹥0.05)。两组患者术后并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论给予浅表性膀胱肿瘤患者经尿道膀胱肿瘤等离子整块剜除术治疗,能够抑制炎症因子、氧化应激因子,不影响患者膀胱功能,且有着一定的安全性。Objective To analyze the effect of superficial bladder tumor applying transurethral plasma enucleation.Method A total of 80 patients with superficial bladder tumor were divided into electrosurgical group(n=37)and plasma enectomy group(n=43)according to different treatment methods.Surgical situation(operation time,intraoperative blood loss,indwelling catheter time,bladder perforation rate),inflammation index[procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],the oxidative stress situation[superoxide dismutase(SOD),cortisol(Cor)],bladder function[International Prostate Symptom Score(IPSS),maximum urine flow(Q_(max))],and postoperative complications of the two groups were compared.Result Compared with the electrosurgical group,the plasma enectomy group had longer operation time,less intraoperative blood loss,and shorter indwelling catheter time(P<0.01).Before surgery,there was no statistical significance in the levels of PCT,CRP,TNF-α,SOD and Cor between two groups(P>0.05).After surgery,the levels of PCT,CRP,TNF-α and SOD were significantly increased,and Cor decreased in both groups,and the level of PCT,CRP,TNF-α and SOD in plasma enectomy group were significantly lower than that in electrosurgical group,and the level of Cor was significantly higher than that in electrosurgical group,with statistical significance(P<0.01).There was no statistical significance in IPSS score,Q_(max) level between two groups before and after surgery(P>0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Treatment of patients with superficial bladder tumors using transurethral plasma enucleation resulted in inhibition of inflammatory factors,oxidative stress factors,and improvement of patient bladder function with a demonstrated safety profile.

关 键 词：经尿道膀胱肿瘤等离子整块剜除术 电切术 浅表性膀胱肿瘤 膀胱功能 

分 类 号：R737.14[医药卫生—肿瘤]