经尿道膀胱肿物电切术治疗腺性膀胱炎疗效的评估及影响因素分析  

Therapeutic effects and influencing factors of transurethral resection of bladder tumor in the treatment of cystitis glandularis

作　　者：李健[1] 方伟林 宋奇翔 宋鑫 吕婷婷 黄金 吉翔 蔡志康 王忠 吕坚伟 LI Jian;FANG Weilin;SONG Qixiang;SONG Xin;LYU Tingting;HUANG Jin;JI Xiang;CAI Zhikang;WANG Zhong;LYU Jianwei(Department of Urology and Andrology,Shanghai Gongli Hospital,Shanghai 200135;Department of Urology,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 201112,China)

机构地区：[1]上海市浦东新区公利医院泌尿男科学部,上海200135 [2]上海交通大学医学院附属仁济医院泌尿外科,上海201112

出　　处：《现代泌尿外科杂志》2024年第8期719-722,共4页Journal of Modern Urology

摘　　要：目的本研究旨在评估经尿道膀胱肿物电切术(TURBT)治疗腺性膀胱炎(CG)的疗效,探究可能影响该手术疗效的因素。方法回顾性分析2013年1月—2020年12月于上海交通大学医学院附属仁济医院和浦东新区公利医院接受TURBT治疗的243例CG患者的临床资料。通过总体反应评估(GRA)来评定术后疗效,使用logistic回归分析探讨患者的人口统计学特征(性别、年龄)、合并症(高血压、糖尿病)、初诊主诉以及术后复发情况与GRA评分的相关性。结果243例患者中,3.70%(9/243)的患者伴有异型增生,2.47%(6/243)的患者伴有布氏巢旺炽性增生,2.06%(5/243)的患者伴有肠上皮化生。患者术后随访(47.10±28.53)个月,术后平均GRA评分为(2.02±0.72)分。10.29%(25/243)的患者因病情复发而进行再次手术,术后肾积水和排尿困难的改善情况分别为70.59%(12/17)和50.00%(15/30),1例(0.41%)患者术后确诊盆腔脂肪增多症。logistic回归分析结果显示患者术后GRA评分与身体质量指数、合并症、酗酒以及术后复发行二次手术等观察指标均无显著相关性(P>0.05)。结论TURBT是治疗CG的一种有效方法,能显著改善患者的肾积水、排尿困难症状,约10%的患者因复发需再次手术,临床医生在治疗过程中需要对可能的疾病复发保持警惕。Objective To evaluate the efficacy of transurethral resection of bladder tumor(TURBT)in treating cystitis glandularis(CG),and to explore the influencing factors.Methods A retrospective analysis was conducted on 243 CG patients treated with TURBT during Jan.2013 and Dec.2020 in our hospitals.Postoperative efficacy was assessed using global response assessment(GRA).The correlation between GRA score and the demographic characteristics,comorbidities,initial complaints,and postoperative recurrence was determined with logistic regression analysis.Results Among the 243 patients,3.70%(9/243)had dysplasia,2.47%(6/243)had exuberant hyperplasia of Brinell s nest,and 2.06%(5/243)had intestinal metaplasia.The mean GRA score was(2.02±0.72)after a follow-up of(47.10±28.53)months.Re-operation was performed in 10.29%(25/243)of the patients due to recurrence,and the improvement of hydronephrosis and dysuria was 70.59%(12/17)and 50.00%(15/30),respectively.Pelvic fat increase developed in 1 patient(0.41%)after surgery.Logistic regression analysis showed that postoperative GRA score was not significantly correlated with demographic characteristics,body mass index,comorbidities,alcoholism and postoperative recurrence(P>0.05).Conclusion TURBT is an effective method in the treatment of CG,which can significantly improve patients hydronephrosis and dysuria.However,approximately 10%of the patients experience recurrence,necessitating further surgery,which suggests the need for vigilance regarding potential recurrence during treatment.

关 键 词：腺性膀胱炎 经尿道膀胱肿物电切术 整体反应评估 术后转归 

分 类 号：R694.3[医药卫生—泌尿科学]