经尿道膀胱肿瘤电切术在早期非肌层浸润性膀胱癌中的应用效果及对患者预后的影响  

Application effect of transurethral resection of bladder tumor in early non-muscle invasive bladder cancer and its impact on patient prognosis

作　　者：刘华 李松鸽 张刘彦 LIU Hua;LI Songge;ZHANG Liuyan(Department of Urology,General Hospital of Zhengzhou Coal Industry(Group)Co.,Ltd,Zhengzhou 452370,He’nan,China;Department of General Surgery,General Hospital of Zhengzhou Coal Industry(Group)Co.,Ltd,Zhengzhou 452370,He’nan,China)

机构地区：[1]郑州煤炭工业(集团)有限责任公司总医院泌尿外科,郑州452370 [2]郑州煤炭工业(集团)有限责任公司总医院普外科,郑州452370

出　　处：《癌症进展》2022年第8期836-839,847,共5页Oncology Progress

摘　　要：目的探讨经尿道膀胱肿瘤电切术在早期非肌层浸润性膀胱癌中的应用效果及对患者预后的影响。方法依据治疗方法的不同将98例早期非肌层浸润性膀胱癌患者分为观察组和对照组,每组49例,对照组患者给予开腹手术治疗,观察组患者给予经尿道膀胱肿瘤电切术治疗。比较两组患者的手术相关指标、氧化应激因子[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]水平、肿瘤标志物[血管内皮生长因子(VEGF)、胰岛素样生长因子1(IGF1)、胰岛素样生长因子结合蛋白3(IGFBP3)]水平、并发症发生情况和随访1年的预后情况。结果观察组患者的术中出血量明显少于对照组(P﹤0.01),尿管留置时间、手术时间和住院时间均明显短于对照组(P﹤0.01)。术后7天,两组患者SOD、GSH-Px、VEGF、IGF1水平均明显低于本组术前(P﹤0.01),MDA、IGFBP3水平均明显高于本组术前(P﹤0.01),且观察组患者SOD、GSH-Px、IGFBP3水平均明显高于对照组,MDA、VEGF、IGF1水平均明显低于对照组(P﹤0.01)。观察组患者尿道狭窄发生率低于对照组(P﹤0.05),膀胱穿孔、闭孔神经反射发生率均高于对照组(P﹤0.05)。随访1年,两组患者的复发率、总生存率均无明显差异(P﹥0.05)。结论经尿道膀胱肿瘤电切术可明显改善早期非肌层浸润性膀胱癌患者的手术相关指标,稳定氧化应激指标,降低肿瘤标志物水平,降低并发症发生风险,与开腹手术治疗的预后无明显差异。Objective To investigate the application effect of transurethral resection of bladder tumor in early nonmuscle invasive bladder cancer and its impact on the prognosis of patients.Method A total of 98 patients with early nonmuscle invasive bladder cancer were divided into observation group and control group according to different treatment methods,with 49 cases in each group.The patients in the control group were treated with laparotomy,and the patients in the observation group were treated with transurethral resection of bladder tumor.The surgery-related indicators,oxidative stress factors[malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)]levels,and tumor markers[vascular endothelial growth factor(VEGF),insulin-like growth factor 1(IGF1),insulin-like growth factor binding protein 3(IGFBP3)]levels,complications and 1-year follow-up were compared between the two groups of patients.Result The intraoperative blood loss volume in the observation group was significantly less than that in the control group(P<0.01),and the urinary catheter indwelling time,operation time,and hospital stay were significantly shorter than those in the control group(P<0.01).Seven days after the operation,the levels of SOD,GSH-Px,VEGF,and IGF1 in the two groups were significantly lower than those before the operation(P<0.01),while the levels of MDA and IGFBP3 were significantly higher than those before the operation(P<0.01),the levels of SOD,GSH-Px,and IGFBP3 were significantly higher than those of the control group(P<0.01),and the levels of MDA,VEGF,and IGF1 were significantly lower than those of the control group(P<0.01).The incidence of urethral stricture in the observation group was lower than that in the control group(P<0.05),and the incidence of bladder perforation and obturator nerve reflex were higher than those in the control group(P<0.05).During the 1-year follow-up,there was no significant difference in the recurrence rate and overall survival between the two groups(P>0.05).Conclusion Transurethral resec

关 键 词：经尿道膀胱肿瘤电切术 非肌层浸润性膀胱癌 氧化应激 肿瘤相关因子 

分 类 号：R737.14[医药卫生—肿瘤]