光动力疗法联合膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的临床效果  

Clinical effect of photodynamic therapy combined with transurethral resection of bladder tumor in the treatment of non-muscular invasive bladder cancer

作　　者：温逸群 苏学锋[1] 庄伟[1] 黄思淮 WEN Yiqun;SU Xuefeng;ZHUANG Wei;HUANG Sihuai(Department of Urology Surgery,the Second Affiliated Hospital of Fujian Medical University,Fujian,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院泌尿外科,福建泉州362000

出　　处：《中国医药科学》2024年第18期123-126,共4页China Medicine And Pharmacy

基　　金：福建省泉州市医疗卫生领域指导性科技计划项目(2021N026S);福建省自然科学基金项目(2022J01273)。

摘　　要：目的本研究旨在评估光动力疗法联合膀胱肿瘤电切术(TURBT)在非肌层浸润性膀胱癌(NMIBC)患者中的疗效和安全性。方法回顾性分析2019年9月至2021年4月于福建医科大学附属第二医院就诊的NMIBC患者30例,按治疗方式分为光动力组(试验组,n=12)以及膀胱肿瘤电切组(对照组,n=18)。试验组治疗方案为光动力照射治疗联合膀胱肿瘤电切治疗,术后行膀胱灌注化疗;对照组治疗方案为膀胱肿瘤电切治疗,术后同样行膀胱灌注化疗。比较两组患者术中出血量、术后住院时间、中性粒细胞水平、淋巴细胞水平、肿瘤复发率以及术后并发症总发生率。结果两组患者术中出血量、术后住院时间比较,差异无统计学意义(P>0.05)。治疗后试验组中性粒细胞、淋巴细胞水平均高于对照组,差异有统计学意义(P<0.05)。试验组肿瘤复发率低于对照组,差异有统计学意义(P<0.05)。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。术后随访的尿液肿瘤标志物NMP 22敏感度偏差较大。结论光动力联合膀胱肿瘤电切术是一种安全、有效的治疗方式,能有效降低NMIBC复发率,且不增加术后并发症发生率。Objective To evaluate the efficacy and safety of photodynamic therapy combined with transurethral resection of bladder tumor(TURBT)in patients with non-muscle invasive bladder cancer(NMIBC).Methods A total of 30 patients with NMIBC admitted to The Second Affiliated Hospital of Fujian Medical University from September 2019 to April 2021 were retrospectively analyzed.They were divided into photodynamic group(experimental group,n=12)and transurethral resection of bladder tumor group(control group,n=18)according to treatment methods.The treatment plan of the experimental group was photodynamic irradiation combined with transurethral resection of bladder tumor,and bladder perfusion chemotherapy was performed after surgery.The treatment plan of the control group was transurethral resection of bladder tumor,and bladder perfusion chemotherapy was also performed after surgery.The intraoperative blood loss,postoperative hospital stay,neutrophil level,lymphocyte level,tumor recurrence rate and total incidence of postoperative complications were compared between the two groups of patients.Results There was no significant difference in intraoperative blood loss and postoperative hospital stay between the two groups of patients(P>0.05).After treatment,the levels of neutrophils and lymphocytes in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).The tumor recurrence rate in the experimental group was lower than that in the control group,the difference was statistically significant(P<0.05),and the incidence of postoperative complications in the two groups,with no statistically significant difference(P>0.05).The sensitivity deviation of urine tumor marker NMP 22 in postoperative follow-up was large.Conclusion Photodynamic therapy combined with transurethral resection of bladder tumor is a safe and effective treatment,which can effectively reduce the recurrence rate of NMIBC without increasing the incidence of postoperative complications.

关 键 词：非肌层浸润性膀胱癌 光动力治疗 光敏剂 膀胱灌注化疗 

分 类 号：R737.14[医药卫生—肿瘤]